Congress Goes Ahead With One-Year Medicare Pay Fix

President Obama passed a bill that will freeze medical pay at present levels for another 12 months.

The new legislation helps you avoid the scheduled 25 percent drop in Medicare pay for the new year.

The up and down ride of conversion factor changes for 2011 has come to a conclusion thanks to a Senate Finance Committee bill that'll freeze Medicare pay at present levels for another 12 months.

The House of Representatives passed the Medicare and Medicaid Extenders Act of 2010 on December 9 and the Senate voted on it the day before. The bill will do away with the 25 percent cut that medical practices were going to face from January 1. President Obama made it official on December 15, 2010 when he signed the year-long delay into law.

Doctors cheered the news that they will not have to wait for the new Congress and Senate members to take their seats prior to finding out whether a payment fix would take place.

The bill passed as a bipartisan effort, and the Senate Finance Committee noted that it'll cost $14.9 billion over 10 years to implement the physician pay fix. It'll be funded by making minor adjustments to the Affordable Care Act, the health care legislation that President Obama signed into law last March.

Last-minute fix is a welcome sight, however not forever

The US Senate passed a quick, 1-month extension of the present SGR formula on November 18 in a first step to avoid the 23 percent payment cut physicians were facing on December 1. The House of Representatives had already recessed for Thanksgiving at that point and took up the one month fix when they returned on November 29.

While many are pleased that the Senate has acted swiftly on the pending payment cut, one remains sceptical about another round of short term fixes. One hopes that the ultimate result of this Congressional session will be a fix of atleast one year. This extended period must then be followed by a strong bipartisan commitment from Congress to work with the physician community to lastly replace the badly flawed SGR formula with a new update mechanism that works. The frequent disruptions and delayed payments caused by the present formula and Congress' inability to fix it except for short periods are simply not fair to our members who have payrolls and other practice management expenses.

Check whether ACF applies

Some pain management coders also code for anesthesia procedures, which means you have a second CF to consider: the anesthesia conversion factor, or ACF.

The 2011 national ACF will remain at $21.5696. Check your specific area; but then as anesthesia reimbursement changes from state to state and even within regions of the same state.

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