Congress Misses Major Medicare Deadline

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Congress failed to pass a bill last week that, among other things, would delay a 21% payment cut to physicians who treat Medicare patients slated to go into effect today.  

The House of Representatives ultimately passed two versions of the American Jobs and Closing Tax Loopholes Act, a  job and tax bill that would have pushed the payment cuts until December 2011. However, the Senate had already adjourned for a week-long holiday recess, causing outrage from various Medicare advocates.

“Senators are more interested in heading home for the holiday than in preventing a Medicare meltdown for seniors,” Dr. J. James Rohack, president of the American Medical Association said in a press release. “This is complete mismanagement of a health care program that America’s seniors and the disabled rely on.”

The bill is now expected to be heard by the Senate when legislators return June 7.  In an effort to give the Senate time to pass this legislation, the Centers for Medicare and Medicaid said in a letter to physicians Thursday that they will hold off paying insurance claims filed for the first 10 business days of June.

If the new version of the bill is amended by the Senate, it will have to return to the House for a re-vote before it is officially passed.

Doctors are split over how they will handle the gap in payment. Dr. Scott Fields, professor and vice chair of the Department of Family Medicine at Oregon Health and Science University, told ABC news, "What I can say is that the easiest thing to do would be to immediately close to new Medicare patients. This would maintain our commitment to established patients, but limit our risk."

Other physicians said they will continue to accept Medicare patients despite the delay in payment of insurance claims.

The House’s delay was caused by concerns over the bill’s price, estimated originally to add $134 billion to the federal deficit. During deliberations, the House was able to cut about $31 billion from the original bill, eliminating $24 billion in aid to troubled states and $7 billion in COBRA health insurance subsidies to unemployed workers.  It cut the price of the bill further when it decided to address the Medicare payment problem in separate legislation.

The new proposed Medicare fix, which passed the House in a vote of 245-171, would increase payments to doctors accepting Medicare coverage by 2.2% for the remainder of 2010 and by 1% through 2011 before reverting to the original 21% cut in January 2012. The Congressional Budget Office estimates that this provision will add $23 billion to the federal deficit.

Regardless of the holiday time glitch, Medicare advocates are clamoring for a more permanent solution to the problem.

“Enough is enough. Nine times in eight years Congress has delayed the cut and not fixed the problem,” Rohack said. “Congress needs to buckle down, stop growing the problem and fix it once and for all to save the Medicare and TRICARE programs for America’s seniors and military families.”

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