Published 12/1/2010
Mary Ann Porucznik

Time’s Running Out on SGR Fix

As this issue of AAOS Now goes to press, the “lame-duck” Congress seems set to approve another short-term fix for physician payments under the sustainable growth rate (SGR) formula for Medicare.

On Nov. 18, the U.S. Senate unanimously approved a 1-month extension of the current patch, retaining the 2.2 percent update in physician payments through the end of the year. Because the House had already recessed for the Thanksgiving holiday, a vote on the “Physician Payment and Therapy Relief Act of 2010” could not be scheduled until Nov. 29 or 30. Without House action, a 23 percent cut in Medicare payments would go into effect on Dec. 1.

The measure offsets the $1 billion in costs over 10 years through reductions in payments for multiple therapy services provided to patients on the same day.

If no further action is taken this year, an approximate 23 percent SGR reduction plus an additional 2 percent reduction in Medicare payments would go into effect on Jan. 1. If action is postponed until the new Congress assembles on Jan. 4, it is likely that the Centers for Medicare & Medicaid Services (CMS) would delay processing claims, as it has done twice this year, for 10 business days to give the new Congress time to act.

Physicians have until Dec. 31 to declare their Medicare status for 2011.

Additional Link:
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Medicare participation options for physicians