March 17 looms for Medicare participation change

Washington, DC

-March 17 is the deadline for physicians to change their Medicare participation status for 2010.

Many physicians may limit the number of Medicare and TRICARE patients they treat after the U.S. Senate did not delay continuation of or repeal the sustainable growth rate (SGR) formula, which is used to determine payment for the treatment of patients who are covered under these insurance programs, at the end of February.

Effective March 1, a 21% (rounded from 21.2%) payment cut went into effect for physicians who care for patients whose treatment is paid for via Medicare or TRICARE.

The U.S. House of Representatives had voted to delay a planned 21% cut in Medicare physician payments until late March.

The American Academy of Ophthalmology (AAO), in a prepared statement, told ophthalmologists that, although the cut would be effective March 1, “disruptions currently are not expected in processing Medicare physician claims, as [the Centers for Medicare and Medicaid Services (CMS)] does not pay claims until at least 10 days after they are submitted. CMS is expected to communicate with participants shortly, but members should expect to submit their claims as they have been (without figuring a 21% cut). CMS presumably will hold those claims for the short term in anticipation of congressional action next week to avert the cut.”

The U.S. Senate voted March 2 “yet again to delay the 21% Medicare physician payment cut for one month, postponing it until April 1,” said J. James Rohack, MD, president, American Medical Association, in a prepared statement. “The Senate should use this time to permanently repeal the flawed Medicare physician payment formula that puts access to care for seniors and military families at risk.”