On June 24, 2010, the U.S. House of Representatives approved the U.S. Senate-passed measure to provide a 2.2% increase in Medicare reimbursement through November 30, 2010. This action once again averts the more than 21% cut to reimbursement facing all Medicare providers.
As both chambers did not agree on a bill before the cuts went into effect, Medicare contractors began processing claims at rates reflective of the 21.3% cut on June 18, 2010. These cuts, resulting from the flawed Sustainable Growth Rate (SGR) formula, technically went in to effect on June 1, 2010, however, the Centers for Medicare and Medicaid Services (CMS) had instructed contractors to hold claims for the first thirteen business days of the month. Now that Congress has acted, CMS will retroactively adjust any June claims that have been paid at the lower rate to reflect the newly passed SGR fix.
Contact your Medicare Administrative Contractor for the most up to date information and any questions you may have
Call or email your member of Congress and ask him or her to pass legislation to address the problems associated with the SGR and produce a long-term solution. Visit the Legislative Action Center on the Academy’s website to offer your input. In addition to the contact information for your legislator, you will also find an editable form letter urging passage of a permanent fix to the Medicare Physician Fee Schedule. Feel free to express your support of this measure in your own words. It takes less than a minute to send letters to your Senators and Representative!
Although Congress is likely to act to again avoid the cuts, the greater than 20% devaluation of many audiology codes, which began January 1, 2010, will continue to remain in effect. This is due to the continued transition of the codes from the Non-Physician Work Pool to work values coupled with the CMS application of a practice expense scaling formula. The Academy, as well as other professional organizations, continues to address these issues with CMS.