Medical Management Strategies

March 2010 Client Alert

rloughlin — Wed, 17 Mar 2010 21:12:00 +0000

Please see the link below to read the March 2010 MMS client alert including Medicare delaying the Pecos enrollment, a summary of the comprehensive error rate testing program, Aetna’s new fee schedule and much more.

Please click this link to read the entire client alert.

Thanks

-MMS

Senate Approves Delaying Physician Pay Cut Until October 1

rloughlin — Thu, 11 Mar 2010 17:24:40 +0000

The Senate voted this afternoon to delay a 21.2% physician pay cut in Medicare reimbursement until October 1.

Overall, the Senate approved a $138 billion package of legislation, including tax extenders and unemployment aid that the White House said is critically important to the country’s economic recovery.

The vote was 62 to 36.

On Tuesday, the Senate voted to limit the bill’s debate, with President Obama saying he was “grateful to members of both parties that helped move forward on this bill, ” said White House Press Secretary Robert Gibbs.

The Senate included an amendment by Senate Finance Committee Chairman Max Baucus, D-MT, to the American Workers, State and Business Relief Act that would delay the Medicare payment cut for physicians—that was supposed to go into effect March 1— until October 1.

The American Medical Association stated the Baucus bill appeared to be a compromise between senators who wanted to implement a one-year payment fix and others who were seeking another “short bridge” to give Congress more time to possibly repeal the formula that calls for annual physician payment cuts.

-Bob

Senate Inches Closer to Delay Doc Pay Cut until September 30

rloughlin — Wed, 10 Mar 2010 17:58:25 +0000

The Senate has cleared the way to vote on delaying a 21.2% physician pay cut vote in Medicare reimbursement until September 30.

In a procedural action, the Senate voted Tuesday to move on a $150 billion package of legislation, including tax extenders and unemployment aid that the White House said is critically important to the country’s economic recovery. The final vote may take place today.

Reacting to the 66-34 vote, President Obama said he was “grateful to members of both parties that helped move forward on this bill, ” according to White House Press Secretary Robert Gibbs. Fifty-eight Democrats and eight Republicans voted for cloture, to limit debate on the measures or a GOP filibuster, which has been a predominant theme in the Senate the last two weeks.

The Senate is considering an amendment by Senate Finance Committee Chairman Max Baucus, D-MT, to the American Workers, State and Business Relief Act that would delay the Medicare payment cut for physicians—that was supposed to go into effect March 1— until September 30.

The Medicare payments were scheduled to be cut across the board in accordance with the sustainable growth rate (SGR) formula. The proposed delay may give Congress time to adjust the SGR formula. SGR links Part B Medicare reimbursement to the gross domestic product. The formula has led to proposed large cuts annually, which physicians have successfully worked to delay.

Physician groups have strongly opposed the SGR formula and some have urged Congress to drop it and rethink the payment process as part of healthcare reform. The pay cut issue has been continually dependent on congressional action. Last week, the Senate and House voted to continue delaying the scheduled pay cut 30 days to April 1. On Dec. 19, Congress voted to delay the scheduled payment cut until March 1.

Special Medicare payment update: President signs extension of physician payment freeze

rloughlin — Thu, 04 Mar 2010 02:55:39 +0000

Late last night, the president signed H.R. 4691, the Temporary Extension Act of 2010 into law. This legislation includes a provision that freezes Medicare physician payments at their current level until March 31, 2010. The legislation also extends the therapy cap exception process through until March 31, 2010. The bill passed the Senate by a vote of 78 – 19. The House of Representatives had unanimously approved a companion bill by voice vote on Feb. 25.

The Senate is also currently debating H.R. 4213 the American Workers, State, and Business Relief Act of 2010. This legislation extends the freeze on Medicare physician payments until Sept. 30, 2010. It also provides an extension to the therapy cap exception process through Dec. 31 , 2010 and an extension of the geographic practice cost index floor through Dec. 31, 2010. If approved by the Senate, the bill would have to be approved by the House before transmittal to the president.

Medicare 10 day business hold for claims processing

rloughlin — Tue, 02 Mar 2010 02:54:00 +0000

You will most likely see a period toward the middle to end of March 2010 where your Medicare payments will slow down, due to the Medicare program holding the processing of all claims for the first 10 business days of March. MMS will diligently monitor the Medicare batches of claims for the next 45 days to make sure all batches are being processed by Medicare after the 10 business day hold is ended on March 15, 2010.

Senate fails to act on 30-day extension, 21 percent Medicare cut effective March 1

rloughlin — Sat, 27 Feb 2010 00:42:38 +0000

Though the House of Representatives unanimously passed a short-term measure Thursday that would extend Medicare’s current physician payment rates and therapy cap exception process through March 31, the Senate failed to act on similar legislation prior to adjourning this week due to Sen. Jim Bunning’s, R-Ky., objections to how to pay for the bill. By law, the 21.2 percent cut to Medicare physician payments will take effect March 1.

The Senate returns Tuesday and will likely attempt to bring up the measure again. Regardless of congressional action, by law, Medicare contractors must hold all claims payments for at least 13 business days after receipt. CMS indicates it will also hold all processing of claims at the reduced rate for the first 10 business days of March, giving the Senate a window to act.

-MMS

Senate discusses delaying 21.2 percent payment cut

rloughlin — Wed, 24 Feb 2010 17:07:11 +0000

Senators are discussing delaying the pending 21.2 percent cut to Medicare physician payments for an additional 15 or 30 days. The extension of the current freeze would likely be included in an “extenders” bill, which would address COBRA, unemployment insurance, the Patriot Act, and highway funding provisions which are also scheduled to expire on Feb. 28. Consideration of this legislation may take place as early as today.

Thanks, Bob

Bob’s Blog – Article I

rloughlin — Mon, 22 Feb 2010 19:23:34 +0000

This will be my first article written for Bob’s Blog. My articles will carry the subject matter of the issues that face all of us who are part of the healthcare industry. Given the issues we face today in the healthcare industry and in our country in general, I will have much to write about and say. So, I hope you find these articles informative and helpful as we all try and make sense out of the direction we are taking when it comes to healthcare in the United States, as well as in our local community.

The most pressing issue we are faced with as I write this first article is the issue of what will Congress decide concerning the current method that is used to determine Medicare reimbursements for physicians. The most current event that leaves one uncertain about will Congress actually do anything between today and March 1, 2010, a mere seven days left to go, to prevent our Medicare reimbursements from decreasing by 21.5 percent. I believe there is a good chance that for the first time in a memorable year Congress may not stop the decrease, at least not stop it before it takes effect and we will all start being paid 21.5 percent less. I think there is a good chance that during this year, 2010, Congress will address the way Medicare reimbursements are calculated and make some changes. The billion dollar question is how Congress will make those changes. There are some good arguments out there that for the next several years’ that Congress will set the method of determining Medicare reimbursements to physicians, by freezing the current payments with no increase or decrease, a small $371 billion added to our trillion dollars or so deficit. We all know that when 30 to 50 percent of our business is frozen with no increased income and 100 percent of our expenses keep going up by 3 to 5 percent per year, we see a constant erosion of our livelihood each year. I think it is probably safe to say, given the current state of our economy and the already additional trillion dollar debt that has been added to our countries already huge federal budget deficit the amount of dollars congress and the White House are willing to allocate toward Medicare reimbursements will not be good. Whatever the final outcome, I do believe it is time for all of us to begin to determine other strategies in our medical practices to sure us up financially for the future and to this end I will be writing about some of those potentially new strategies in future articles.

In ending my first article, I just want to say, I look forward in writing many more articles and getting your responses back as to if the articles where of interest or not to you.

My Best Regards,

Bob

bsayers@mmsofslo.com

Senate still with no strategy to address the 21.2% Medicare pay cut

rloughlin — Tue, 16 Feb 2010 23:23:33 +0000

With a 21.2% Medicare pay cut looming less than two weeks away, many (including the United States Senate) are left wondering how this issue will continue to be addressed.

With no clear legislative strategy in sight, the Senate is exploring a continued freeze on physician payments for up to an additional seven months.

In related news President Obama has scheduled a nationally televised healthcare summit in hopes of reenergizing healthcare reform.

To read the entire article from the MGMA please click here.

As always, MMS will continue to monitor the situation and keep you updated.

What should my EHR be doing?

rloughlin — Fri, 12 Feb 2010 13:35:41 +0000

Ever wonder what your electronic health record NEEDS to be doing in order to meet the requirements of meaningful use?

Well CMS & HSS have published some general guidelines to help guide physicians in the right direction.

Medical Management Strategies has taken some time to summarize these guidelines in a pdf available here.

Please feel free to contact Ryan Loughlin at rloughlin@mmsofslo.com for any further questions you may have.