MEDICARE REIMBURSEMENT RATES 2008 UPDATE 2 July 2008
Posted by Service Officer on July 2nd, 2008
MEDICARE REIMBURSEMENT RATES 2008 UPDATE 10: On 24 JUN, the House overwhelmingly passed H.R.6331, Medicare Improvements for Patients and Providers Act, which would have stopped the payment cuts, substituted a small increase for doctors seeing Medicare and TRICARE patients, and prevented the therapy cutoff. The vote was a solid veto-proof 355-59 with 20 not voting. This bill was almost identical to one rejected by the Senate two weeks ago. But Senate Republicans and President Bush didn’t approve of the funding source for that fix (cutbacks in some Medicare Advantage programs that pay doctors up to 17% more than regular Medicare does), and pushed an alternative bill. Medicare Advantage is but a small portion of those dependent upon Medicare. After the overwhelming House vote, Senate leaders tried to bring the bill up for a vote anyway. But when Republicans objected, they needed 60 votes to overcome the objection. On 26 JUN at 8:20PM, they got 58 with 40 nays and two not voting. Not enough to even get a vote, let alone override a threatened presidential veto. Republicans then proposed extending the current rates for 30 days to allow more time for a fix. But that was a non-starter, since the House had already left town for recess, and the Senate can’t approve a new fix by itself.
Congress took a week’s vacation over Independence Day and promised to fix things when they return. Now Medicare payments to doctors will be cut 10.6% starting 1 JUL. Also as of July 1, speech, physical or occupational therapy patients for whom Medicare has already paid at least $1,810 for therapy in 2008 will have further Medicare payments for that care stopped. (NOTE: Tricare doesn’t have a therapy payment cap like Medicare does, so Tricare therapy patients should be okay. For Tricare For Life patients, Tricare will pick up payments when Medicare stops, BUT only after the $150 annual Tricare deductible has been satisfied, along with applicable copays.) Tricare patients have a little more breathing room. Although Tricare doctor payments are tied to Medicare’s, there’s usually about a month’s delay in updating Tricare payment files when Medicare makes a change.
This isn’t the first time Congress has failed to stop a Medicare payment cut. In 2006, Congress missed the deadline, but approved a fix within a few weeks and made it retroactive. That caused doctors and Medicare administrators lots of headaches in the interim, but in the end, the lost payments were made up. And Tricare patients were never affected, because Congress fixed the rates before TRICARE got around to implementing the cuts. That’s the best-case scenario now - if Congress can act quickly after 4 JUL to approve a fix the president will sign. But the risk remains that some number of fed-up doctors will decide not to accept any more Medicare or Tricare patients and some may even turn away current Medicare/Tricare patients. Whatever Congress does after 4 JUL, they could have done before 1 JUL and prevented this mess. Actually, they have had since 2002 to fix the problem but have only applied a band-aid fix each year. If the President, the House, the Senate, Republicans, and Democrats had been willing to compromise — just a little — health care access for our seniors and military beneficiaries need not have been put at risk in this irresponsible way. All active duty and retire personnel with Tricare are encouraged to go to http://capwiz.com/usdr/issues/alert/?alertid=11554371&queueid=[capwiz:queue_id] , enter your zip code, and send a message to both of your Senators to work out their differences on this issue.
Note: The Bush Administration announced 27 JUN 08, that it will hold all Medicare claims from doctors for the first 10 business days of July and that it will make no payments at the 10% reduced reimbursement rate until 15 JUL at the earliest. This positive step by the administration gives Congress a window of time to come together on a reasonable, bipartisan Medicare bill to eliminate the 10% cut in Medicare payments to doctors. [Source: USDR Action Alert 27 Jun 08 ++]
