The Continuing Extension Act of 2010 prevented a 21.2% reduction in Medicare Part B payments by extending the 2009 rates through May 31, 2010. Today, June 18, 2010, the Senate passed H.R. 3962, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, by a unanimous voice vote. This legislation provides a 2.2% Medicare physician payment update for six months, from June 1 through November 30, 2010. Unfortunately, the House cannot act until next week—most likely Tuesday, June 22. Therefore, the 2010 Medicare Physician Fee Schedule rate and 21.2% reduction has been in effect since June 1. Once the legislation is passed by the House and signed by the President, CMS will retroactively adjust any June claims that have been paid.
The Centers for Medicare and Medicaid Services (CMS) instructed its contractors to hold claims for services paid under the 2010 Medicare Physician Fee Schedule until June 17, 2010. The legislation that passed the Senate is retroactive to June 1. CMS wanted to avoid having to reprocess claims paid under the 21.2% reduction.
As of today, June 18, contractors will begin processing claimsat the reduced rate unless CMS instructs them to hold claims. If you are a participating provider in Medicare (i.e., a provider that receives payments directly from Medicare), you may want to delay billing a patient for co-payments until new legislation is approved by the House next week. Otherwise, participating providers may bill a co-payment as applied to the 21.2% reduced rate and then have to re-bill the patient for the difference in the co-payment when rates are adjusted. Similarly, non-participating providers (i.e., a provider that receives payment from patients) may want to delay billing patients both the co-payment and the charge for the service. If providers do choose to bill patients prior to the rate adjustments, they should inform the patient that there will be an upward bill adjustment when the adjustment becomes effective by congressional action.
Once H.R. 3962 is passed by the House and signed by the President, CMS will retroactively adjust any June claims that have been paid.
View the Senate's press release, on the passage of this legislation on the Senate's Web site and ASHA's analysis of the 2010 Medicare Physician Fee Schedule, on ASHA's Web site. For further information, please contact Kate Romanow, ASHA's director of health care regulatory advocacy, at 301-296-5671 or email@example.com; or Mark Kander, ASHA's director of health care regulatory analysis, at 301-296-5669 or firstname.lastname@example.org.