Medicare Fee Alert-June 21, 2010, by Dr. Ron Short

by 
June 21st, 2010

June 21, 2010

Well, hasn’t this just been an interesting weekend?  If you have seen virtually any news media you know that the Senate failed to pass the Extenders Bill that would have extended many programs through the end of 2011, including the freeze on the massive 21.5% cut in the Medicare Physician Fee Schedule, and that on Friday Medicare started processing those claims that they had been holding with the 21.5% cut in place.

You also know that the Senate took the House version of the Healthcare bill, stripped all the language from it, and added an amendment that would extend the freeze on the 21.5% cut through the end of November. 

So, what does this mean to you? 

The bill that passed the Senate on Friday has to be passed by the House in a full vote and they will not be back in session until 6 P.M. tomorrow. Speaker Pelosi has stated in a press release: “I see no reason to pass this inadequate bill until we see jobs legislation coming out of the Senate.”  It is very possible that she will not allow the bill to come up for a vote.

Medicare will continue to process Medicare claims with the cut in place until Congress passes one of these bills and the President signs it.  A copy of the notification that was sent to Congress this morning is copied in full below:


From: Wright, Frankeena (CMS/OL)
Sent: Monday, June 21, 2010 8:36 AM
Subject: Hill Notification: The 2010 Medicare Physician Fee Schedule

U.S. House and Senate Notification

Monday, June 21, 2010

To:      Congressional Health Staff

From:  Amy Hall

            Director, Office of Legislation

            Centers for Medicare & Medicaid Services

Re:     The 2010 Medicare Physician Fee Schedule

The Continuing Extension Act of 2010, enacted on April 15, 2010, extended the zero percent update to the 2010 Medicare Physician Fee Schedule (MPFS) through May 31, 2010. 

On May 27, 2010, the Centers for Medicare & Medicaid Services (CMS) initially instructed contractors to hold claims for services paid under the MPFS for the first 10 business days of June. On June 14, CMS extended this hold for an additional three business days (i.e., through June 17, 2010). This hold only affected MPFS claims with dates of service of June 1, 2010 and later. 

Last Friday, CMS directed contractors to lift the hold and begin processing June 1 and later MPFS claims under the law’s negative update requirement.  Held claims will be released and processed on a flow basis, first-in/first-out.

Congress continues to debate the elimination of the negative update that took effect June 1, 2010.  The CMS is hopeful that Congressional action will be taken to avert the negative update.  We continue to monitor Congressional actions, and if Congress changes the negative update that is currently in effect, we are prepared to act expeditiously to make the appropriate changes to Medicare claims processing systems.

Thank you.


Both bills are worded to be retroactive to June 1.  If you submit a Medicare claim now, it will be paid, but at a rate that is 21.5% less than you normally get. When the legislation goes into effect, Medicare will pay you the difference. 

You now have a choice:

  1. Continue to hold your Medicare claims and wait for one of these two bills to pass or,
  2. Submit your claims now, take the cut, and wait for Medicare to make up the difference in the future.

Only you can decide what is best for your practice and your situation.  Frankly, this has gone longer than I expected.  It could end quickly or drag on for a few weeks longer.

If you have any questions, please feel free to contact me.

Dr. Ron Short, DC, MCS-P

Heartland Consulting Group

217-285-2300

drron1085@gmail.com

Medicare Fee Alert-June 21, 2010, by Dr. Ron Short. (2010, June 21). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/medicare-fee-alert-june-21-2010-by-dr-ron-short-25639.html

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