January 9, 2011

January 9, 2011
Medicare Reimbursement to Doctors


Welcome to another day in my life. Today is Monday and I hope you had a safe and great weekend. It was a very long weekend for Dab the AIDS Bear and me as we were housebound due to a bad case of the flu. I do not remember the last time it took us over a week to get over something this bad.

A lot of people with HIV end up on Medicare at some time while living with the virus. So what does that mean and what is happening to the reimbursements to their doctors? That is what I am going to blog about today.

A 20-member conference committee is expected to begin meeting the week of Jan. 16 on a full-year extension of the payroll tax holiday and to ensure physicians' Medicare reimbursement is not cut at the beginning of March, congressional aides said Jan. 3.

The aides expect House Ways and Means Committee Chairman Dave Camp (R-Mich.) to chair the conference committee and convene the group's first meeting after the House returns from its winter recess on Jan. 17. The conference committee is made up of eight House Republicans, five House Democrats, four Senate Democrats, and three Senate Republicans.

A majority of conferees from each chamber is needed for the conference report to be approved and sent for a floor vote in each chamber. Lawmakers in both houses of Congress agree on the need to extend the Social Security tax rate at the current 4.2 percent for individuals, but finding a way to pay for the $100 billion tax cut has been the key sticking point.

President Obama Dec. 23 signed payroll tax cut legislation (Pub. L. No. 112-78) that defers until the end of February a scheduled 27 percent Medicare pay cut for physicians that was due to be implemented Jan. 1 (248 HCDR, 12/28/11).

Looming Deadline

The president signed the measure after the House and Senate earlier approved it by unanimous consent. Passage of the Temporary Payroll Tax Cut Continuation Act of 2011 provides only temporary relief for physicians as they are now faced with another looming deadline in which their Medicare payments could be reduced.

The law also extends for two months expiring Medicare payment provisions for numerous providers, including hospitals, nursing homes, and ambulance service providers. It is unclear what House and Senate negotiators will come up with to cancel the cut and extend other Medicare payment policy. Some stakeholders say Democrats and Republicans remain bitterly divided on most policy, which could make it difficult for lawmakers to do more than approve more short-term physician payment fixes.

CMS Recalculating Payments

Physicians' Medicare reimbursement was slated to be cut 27 percent Jan. 1 before Obama signed the payroll tax cut bill. In a Jan. 4 e-news release, CMS said it is recalculating the 2012 Medicare Physician Fee Schedule to implement the zero percent update provided in the law signed by Obama Dec. 23.

The agency said all claims with dates of service after Jan. 1 would be released for processing "no later than January 18." Claims submitted before 2012 will not be affected by the change, CMS said.

Medicare contractors will be posting the new rates on their websites no later than Jan. 11, CMS said.

White House spokesman Jay Carney said Jan. 3 the White House is optimistic conferees can find a way to reach an agreement before March.

"We believe that it is inconceivable that Republicans in Congress would want to go through this process again and somehow prevent it from happening. It would be bad for the economy and bad for 160 million Americans. So we believe it it is a must do and it will happen," Carney told reporters.

Conferees Appointed

Senate Minority Leader Mitch McConnell (R-Ky.) Dec. 30 named the final three conferees to committee, appointing Sens. Jon Kyl (R-Ariz.), Mike Crapo (R-Idaho), and John Barrasso (R-Wyo.).

"As we move into the new year, it is crucial for everyone to realize that, once this temporary extension is behind us, the larger goal is to move beyond a discussion of temporary assistance, and toward a bipartisan plan to get our economy moving again, reform the tax code, and preserve and protect entitlement programs for future generations," McConnell said.

Senate Democrats already named to the conference committee were Finance Committee Chairman Max Baucus (D-Mont.), Benjamin Cardin (D-Md.), Jack Reed (D-R.I.), and Robert Casey (D-Pa.). On the House side, Minority Leader Nancy Pelosi (D-Calif.) named Reps. Sander Levin (D-Mich.), Xavier Becerra (D-Calif.), Chris Van Hollen (D-Md.), Henry Waxman (D-Calif.), and Allyson Schwartz (D-Pa.). In addition to Camp, House Speaker John Boehner (R-Ohio) has appointed Reps. Kevin Brady (R-Texas), Renee Ellmers (R-N.C.), Nan Hayworth (R-N.Y.), Tom Price (R-Ga.), Tom Reed (R-N.Y.), Fred Upton (R-Mich.), and Greg Walden (R-Ore.).

Now you know the rest of the story. So what can you do to make a difference? Call your elected officials in Washington DC and let your voice be heard.

Until we meet again; here's wishing you health, hope, happiness and just enough.



big bear hug,





Daddy Dab