Earlier this year, Congress enacted a short-term fix to ensure that physicians did not see drastic reductions in their Medicare reimbursements – an issue that has been plaguing lawmakers and physicians alike for years, due to a payment formula that has routinely scheduled reimbursement reductions.
Though fixing the issue has received consistent bipartisan support, providing a permanent remedy has been too costly for Congress to stomach, resulting in a series of short-term patches over the past several years instead.
The current, temporary fix expires on November 30, by which time Congress will have to enact another extension, or physicians will face a reimbursement cut of 23 percent on December 1, followed by another 6.5 percent at the beginning on 2011. This timing makes it likely that issue will be addressed when Congress reconvenes for its post-election lame duck session the week of November 15.
The American Medical Association (AMA) and other physician organizations have strongly urged lawmakers to enact a long-term fix to the problem, citing the highly disruptive nature of reimbursement uncertainties and the potential for providers to stop seeing Medicare patients altogether – a scenario that could jeopardize access to care for many seniors.
In a September 29 letter to House Leadership, the AMA and others noted that without Congressional intervention, the next cut in payments is scheduled to occur at a time “…when physicians may change their status from a Medicare participating physician, who accepts Medicare’s allowance as payment in full, to a non-participating physician who may bill patients more than the Medicare allowance.” Given the payment disruptions that have occurred in 2010 alone, the letter also noted the possibility that physicians will be deciding whether or not it makes sense to continue participating in the Medicare program.