Medicare Compliance & Reimbursement

If you were hoping for a last-minute congressional fix to the 2008 Medicare payment woes -- and who wasn't? -- chances are that you won't get your wish until the New Year. In fact, the Senate and House may ensure that the Medicare bill stays in limbo as they go on their holiday breaks.

Although Senate Finance Chair Max Baucus said in a Dec. 5 news release, "It's important to move as quickly as possible toward a final Medicare bill before the end of this year," lawmakers appeared to be at an impasse by Dec. 11. On that date, Baucus told reporters, "Medicare may be pushed off until next year," noting that the White House had pledged to veto any Medicare bill that was funded in part by cutting reimbursement to Medicare Advantage plans.

Because legislators may adjourn for the year before hammering out a Medicare deal, odds are strong that you'll have to wait until January before you find out whether you'll get a reversal from the planned 10.1 percent cut that CMS announced in the Medicare Physician Fee Schedule.

Retroactive changes may be possible: If Medicare does change the Fee Schedule in January or later, there is a good chance that they may make it retroactive to Jan. 1, 2008, which has happened in prior years.

"In 2003, Congress did the same thing where they didn't fix the Fee Schedule until March of that year, so in July 1 of 2003, they made an adjustment for what they underpaid practices for the first quarter," says Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-OTO, CHCC, director of outreach for the American Academy of Professional Coders in Salt Lake City.