Part B Insider (Multispecialty) Coding Alert

Published on Wed Jul 04, 2007 PDF

Once again, Congress opts for a short-term fix to your pay crisis

When it comes to Medicare legislation, you-d better hope the House always wins.

Good news: The House of Representatives passed a bill, late on Aug. 1, which would scrap the 10 percent cut you-re facing in 2008, as well as the 5 percent cut looming for 2009. Snag: The Senate looked set to pass a bill that addresses children's health but leaves Medicare alone.

When the House and Senate return from their August recess, they will face the task of forming a conference committee to decide between the two bills, says Julius Hobson, former chief lobbyist for the American Medical Association and an attorney with Powell Goldstein Frazer & Murphy in Washington.

President Bush has promised to veto either version of the bill, but administration officials sounded especially vehement in their objection to the House's reimbursement-friendly version. Rationale: The House bill threatens Medicare's fiscal solvency and increases spending unnecessarily, claims a July 26 letter from HHS Secretary Michael Leavitt to members of Congress.

Some Republicans suggested Bush is less likely to veto the Senate bill, according to press reports.

Bad news: At the last minute, House Democrats had to scale back their bill's provisions affecting Medicare physicians to avoid   costing money in the long term.

The original bill would have guaranteed that your rates would have  risen at the same rate as the Gross Domestic Product (GDP) starting  in 2010, or GDP growth plus 3 percent for primary care.

The new version of the bill just eliminates the cuts for 2008 and 2009, leaving you facing a bigger cut in 2010. Some sources predicted the 2010 cut could be as high as 16 percent, but Hobson said it could be closer to 10 percent again. Physicians receive increases of -0.5 percent in 2008 and 0.5 in 2009, then you fall off the cliff,- says Hobson.

Rep. Fortney -Pete- Stark (D-CA) has said he wants to spend the next two years crafting a new formula to control the growth in physician spending without endangering access, says Hobson.