First a pay cut, then a pay freeze, then a pay increase, so what’s happening with the June Medicare claims? Here’s up-to-date information for you.
The Centers for Medicare & Medicaid Services (CMS) issued a statement indicating claims with June 2010 dates of service paid at the negative rate will be reprocessed as soon as possible. However, the ISMA has heard from members that they are being paid at the new rate.
Your claims filed for June dates of services and submitted with charges greater than or equal to the new 2.2 percent update will be reprocessed automatically by National Government Services (NGS). You do not need to take any action on these claims.
If you filed claims with June dates of service and charges less than the 2.2 percent update, contact NGS to request an adjustment.
For more details, see the AMA website here.
If you still have questions, call Jeri Biedenkopf, R.N., the ISMA practice advisor for Medicare.
Final June action on Medicare
On June 24, the U.S. House of Representatives passed H.R. 3962, the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, replacing the scheduled Medicare physician payment cut with a 2.2 percent pay update.
An identical version of the bill had passed the Senate earlier, so as soon as President Obama signed the bill June 25, it became law.
On signing the bill, President Obama said, “I believe we need to permanently reform the Medicare formula in a way that attacks our fiscal problem without punishing our hard-working doctors or endangering the benefits on which so many of our seniors rely. I look forward to working with Congress to achieve that goal…”
Your future with Medicare
In a proposed rule, CMS included a provision to potentially reduce physician pay under the Sustainable Growth Rate (SGR) formula by an additional 6.1 percent Jan. 1, 2011. That’s in addition to a 23.5 percent scheduled to occur in December.
Do you agree the solution is to abolish the SGR formula? Then be sure to sign the petition initiated by the ISMA and other medical societies; get your family and friends to sign as well. The goal is to secure 1 million signatures by August.
The petition urges Congress to fix Medicare by developing a rational Medicare physician payment system that automatically keeps up with the cost of running a practice and is backed by a fair, stable funding formula. To access the petition, visit www.ismanet.org and find the information under the news and announcements banner.