Senate fails to pass 30-day "doc fix" to prevent 21.3% Medicare payment cut for physicians effective April 1st

The Senate has adjourned for its two-week spring recess without approving H.R. 4851, a short-term measure that would have extended the freeze on Medicare’s current physician payment rates through April 30.

Several Senate Republicans led by Tom Coburn of Oklahoma objected to classifying the bill, which also included extensions of unemployment benefits and COBRA insurance, as emergency spending. The House of Representatives passed the bill on March 17. By law, the 21.3 percent cut to Medicare physician payments will take effect April 1.

However, in similar situations in the past, the Centers for Medicare & Medicaid Services (CMS) has instructed carriers to temporarily hold claims. While CMS has not made this announcement yet, we exect that CMS will hold claims for the first 2 weeks of April.

The Senate returns April 12 and has scheduled a cloture vote on the 30-day extension bill for 5:30 p.m. that evening. Physician offices should contact their Senators and urge them to permanently address this issue by repealing the sustainable growth rate (SGR) formula. This is frustrating and disappointing but as long as Congress acts on April 12th there will hopefully not be an impact for physicians due to the normal lag in claims processing by CMS.