Enactment of Doc Fix Bill Offers Another Temporary Reprieve for Medicare Physicians

The Doc Fix Fixes a Broken Medicare Payment System.

(June 28, 2010): On Friday, June 25, 2010, President Obama signed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (H.R. 3962), commonly referred to as the Doc Fix, which provides yet another band-aid for our broken Medicare physician pay system. The bill replaces the 21% Medicare physician payment cut that took effect at the beginning of this month with a retroactive 2.2% payment increase for the period from June 1 to November 30.

What this increase means, of course, is that after November 30, 2010 physicians’ pay is expected to tumble 23%, instead of 21%. This bill is just the latest in a series of Congress’ short-term Doc Fix budget maneuvers, designed to stave off the deleterious impacts of the fundamentally flawed Sustainable Growth Rate (SGR). The fact is that the constant cycle of SGR-mandated pay cuts and uncertain legislative patches punishes doctors and patients.

Upon signing the bill, the President issued a statement, noting that, “A 21-percent pay cut to physicians’ payments would have forced some doctors to [stop] seeing Medicare patients – an outcome we can all agree is unacceptable.” We imagine that a 23% drop in December will be similarly unacceptable but, at this point, Medicare physicians (and patients) will be forced to continue operating without any certainty of a long-term solution.

The Centers for Medicare and Medicaid Services (CMS) have been processing claims at the lower rate since June 18 but will reprocess these and begin processing future claims at the increased pay rate by July 1. Physicians should carefully monitor their claims for this period and ensure that CMS contractors make the necessary adjustments.

Health Care Attorney

Should you have any questions regarding these issues, don’t hesitate to contact us. For a complementary consultation, you may call Robert W. Liles or one our other attorneys at: 1 (800) 475-1906.