ALERT! House Members Go Home without Doc Fix; CMS Tells Contractors to Process 21 Percent Payment Cut

Meanwhile, CMS has directors its contractors to begin processing the 21 percent payment cut to physicians.  In an e-mail to both Congress and to its physicians listserve, CMS indicated that it will not extend the current hold on physicians’ claims.  The agency had been holding payments since June 1.  For more, please see article below. 
 

From

Senate Democrats failed again Thursday to get the necessary 60 votes to approve extensions of unemployment benefits, higher Medicare reimbursements, and lapsed tax breaks for businesses and individuals. The vote was 56-40, with Democratic Sens. Ben Nelson of Nebraska and Joe Lieberman of Connecticut crossing the aisle to vote against cloture on the bill.

But the point was moot, as House Democratic leaders Thursday released their members to head home for the weekend, apparently recognizing there wasn't enough time both for the Senate to get a deal and take it up in the House.

Senators on both sides of the aisle were still registering concerns, even as the number of laid-off workers losing benefits is estimated to nearly triple, to 903,000, as Congress leaves town without approving the bill. As early as today, physicians who treat Medicare patients would begin to see their payments cut 21 percent.

Senate Finance Chairman Max Baucus has cut the deficit impact of the measure nearly in half, to $55 billion over a decade, from an initial version the Senate approved in March that six Republicans voted for.

Senate Democrats kept working, perhaps planning to trim the last major un-offset piece of the package -- $24 billion in state Medicaid funds.

That would be a major blow to governors, public-sector unions and the Obama administration, which dispatched a Saturday night letter to congressional leaders pleading for the money. House Democratic leaders had to drop the Medicaid money altogether to win enough votes in their chamber, with the expectation it would be added to another vehicle later.

But advocates reacted furiously to the House move, and Baucus and Senate Majority Leader Reid have done their best to keep the Medicaid funding in the Senate version, even trimming unemployment insurance checks by $25 per week.

Reid said he was negotiating with Senate Republicans to set up votes on final passage, but Republicans including Sen. Tom Coburn of Oklahoma were still pressing their amendments.

Coburn employed a parliamentary move splitting an offset package he offered into 20 different amendments, known as a "clay pigeon" maneuver, which amounted to his own mini-filibuster. Sen. Olympia Snowe, R-Maine, who Democrats were wooing to support their bill, still has concerns and was meeting with Minority Leader McConnell Thursday afternoon. She is seeking to strike a $9 billion tax increase on S corporations involved in providing services, but there was no agreement enabling her to offer that amendment.

"Nothing has changed," Snowe said.

Republicans argued an alternative they offered would extend worker benefits and provide a lengthier delay in physician pay cuts, all of it paid for by cutting federal spending instead of raising taxes. "We want to do something groundbreaking around here -- we want to pay for it," said Sen. John McCain, R-Ariz.

Physician payments, which have already taken a steep hit -- from a five-year fix costing $88.5 billion down to a six-month, $6.5 billion fix

-- might also have to be scaled back further to win votes. And one $400 million healthcare provision specifically benefiting California was coming in for particular criticism, including from Snowe.

Coburn targeted the provision in one of his amendments, and he and others took turns skewering it on the floor. "Yet another special deal for just one state," Finance ranking member Chuck Grassley said, recalling the healthcare debate.
 

 

The CMS said it has directed Medicare contractors to begin processing physician reimbursements for the month of June with the scheduled 21.2% cut mandated by law.

In an e-mail sent to congressional staffers and in a message posted to its physicians listserv, the CMS that it would not extend the current hold on physicians’ claims—something it has been doing since June 1 in anticipation of congressional action that would halt the cuts.

“Congress continues to debate the elimination of the negative update,” the message states. “The CMS is hopeful that congressional action will be taken to avert the negative update.”

It continues: “If Congress changes the negative update that is currently in effect, we are prepared to act expeditiously to make the appropriate changes to Medicare claims processing systems.”

An extension by the CMS expired today while the Senate remained gridlocked over how to patch the long-troubled Medicare payment formula.

Lobbyist sources said that Senate leaders reached a deal on a six-month, 2.2% update, which would be offset from other spending. But even if the Senate could pass the measure—a tall order among its divisive ranks—the House has adjourned until next week, meaning a law could not pass before then.