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Doc Fix

Extreme disruption of Medicare funding forecast if Affordable Care Act is tossed out

McKnight's Staff April 25, 2012

Healthcare experts on both sides of the political spectrum are warning that the Medicare program could unravel if the Supreme Court deems the Affordable Care Act unconstitutional. Nursing homes, and others might not get paid, at least one expert says.

'Doc fix' might hurt a little

John O'Connor February 24, 2012

President Obama has signed legislation that delays a pay cut for doctors treating Medicare patients. That comes as good news for physicians, but not so much for nursing facilities.

'Doc fix' moves on to White House

February 17, 2012

A bill that contains legislation cancelling a scheduled Medicare reimbursement cut to physicians has passed the House and Senate.

GOP senators float 'premium support' Medicare overhaul

February 17, 2012

A new Medicare overhaul proposed by two Republican senators on Thursday would save an estimated $200 billion to $500 billion over 10 years by way of "premium support."

Congress returns to full action; focus turns back to therapy cap process, docs and State of the Union

January 20, 2012

The U.S. Senate ends its recess Monday, six days after the House reconvened. That sets the stage for more intense lobbying over healthcare spending and other measures, including the Medicare Part B therapy caps exceptions process and how to fund Medicare doctors. Both were part of a two-month reprieve Congress approved shortly before Christmas. Long-term care providers and numerous other special interest groups will continue their blitz of lawmakers and their staff members in attempts to curry favor for what should be a much longer legislative solution this time. Also on tap: Watching intently Tuesday to see whether long-term care is mentioned in President Obama's State of the Union address.

Congress votes to prevent whopping physician pay cut

December 23, 2011

The House and Senate voted Friday morning to pass a two-month extension of the so-called "doc fix," preventing a scheduled 27.4% cut in Medicare payments for physicians.

Physician pay cut uncertainty could crash Medicare computer system, official warns

December 21, 2011

The Centers for Medicare & Medicaid Services has warned that its computer systems could crash due to a backlog of claims unless Congress acts to prevent a scheduled 27.4% physician pay cut.

New 'doc fix' solution could be on the way following House vote on payroll tax cut bill

December 21, 2011

Amidst a wave of criticism from provider groups and patient advocates after the vote, Reps. Phil Gingrey (R-GA) and Michael Burgess (R-TN) indicated they are in favor of developing a stand-alone "doc fix" bill in a separate conference committee. Both men are physicians.

CMS instructs contractors to hold physician payment claims as House votes down payroll tax cut bill

December 20, 2011

The Centers for Medicare & Medicaid Services has instructed claims contractors to withhold physician payment claims for the first 10 days of 2012, citing Congress' inability to address the "doc fix."

Providers tense, as House leaders vow to vote around Senate-approved measure with 'doc fix' and therapy cap extender bills

December 19, 2011

Provider groups were anxiously awaiting a vote that is expected to be held Tuesday in the U.S. House of Representatives. The balloting could determine the short-term fate of Medicare spending for the "doc fix" and an extension to the therapy caps exception process.

GOP bill discounting Medicare bad debt ignites skilled nursing backlash

December 12, 2011

Advocates for skilled nursing operators started a counteroffensive Monday in Washington to fight bad-debt provisions of a new House GOP spending bill. Introduced Friday, the bill asks skilled nursing operators to absorb more than $4.5 billion of $10 billion in bad debt losses.

GOP bill would extend Medicare therapy caps exceptions process, delay physician pay cut for two years

December 09, 2011

House Republicans introduced legislation Friday that would extend the outpatient therapy caps exception process. Without Congressional action, the caps would go back into full effect Jan. 1. The proposed legislation also would postpone huge Medicare doctor pay cuts by two years through a package that would scuttle parts of the healthcare reform law.

President's budget proposal cuts Medicaid payments to providers by $28.8 billion over 10 years

February 15, 2011

President Obama released his $3.7 trillion budget for FY 2012 Monday, and it would lower Medicaid payments to healthcare providers by $28.8 billion over 10 years.

Ode to the lame-duck session

Liza Berger December 22, 2010

Lawmakers have been earning their keep lately. Given all the legislation that has passed, I could not resist writing this little holiday poem.

President signs Medicare extenders bill, Congress passes bill to create HHS national Alzheimer's project

December 17, 2010

President Obama this week signed a measure that will extend the therapy caps exceptions process through 2011, restore the implementation date of RUG-IV to 2010 and delay a Medicare payment cut to doctors.

The road to the RUG-IV-related repeal

Liza Berger December 10, 2010

Some good news—and just in time for the holidays. Nursing home providers can ring in 2011 knowing that residents will not be denied Medicare Part B outpatient therapy and the RUG-IV system won't change.

SPECIAL BULLETIN: House votes to repeal RUG-IV delay, extend therapy caps exception process

December 09, 2010

Medicare's RUG-IV system that began in October will remain in place, thanks to a $19.2 billion package passed today in the House of Representatives. The legislation also extends Medicare's therapy caps exception process until the end of 2011. The 409-2 vote comes one day after unanimous passage in the Senate. President Obama is expected to sign the measure into law once it reaches his desk.

Senate closer to finalizing 'doc fix'

December 08, 2010

Staff members representing Harry Reid (D-NV), Max Baucus (D-MT) and Charles Grassley (R-IA) reportedly have been finalizing an agreement on a one-year solution to the Medicare "doc fix." Senate leaders hope to send it to the floor of the Senate as early as today, Politico.com reported.

Open up and say 'Aha'

James M. Berklan December 01, 2010

OK, raise your hand if you were surprised to learn that physicians averted a major Medicare pay cut that was supposed to take place this week. Didn't think so. I wasn't either.

House passes one-month 'doc fix'

November 30, 2010

Following the Senate's lead, the U.S. House Wednesday voted to extend current Medicare reimbursement rates for physicians through the end of the year. Other items, including legislation affecting the long-term care community, are on Congress's to-do list during this lame-duck session.

Senate votes to postpone payment cut to Medicare docs

November 22, 2010

To the relief of physicians everywhere, the Senate voted Thursday to put off a 23% cut in Medicare pay for doctors until Dec. 31.

Doctors wait patiently for Congress to act on 'doc fix'

November 16, 2010

Doctors across the United States are taking a wait-and-see approach while Congress decides whether or not to allow a scheduled 23% cut in Medicare reimbursement rates to take effect on Dec. 1.

Commission takes the knife to healthcare spending

Liza Berger November 12, 2010

Preliminary recommendations from a new commission gave long-term care providers a bit of a fright this week. And understandably so.

AHCA disagrees with CMS decision to implement new multiple procedure payment reduction rule

November 04, 2010

The American Health Care Association spoke out this week after the Centers for Medicare & Medicaid Services said it is implementing a new payment reduction policy for therapy services because of a "duplication in the practice expense when therapy services are furnished together."

AHCA gears up for annual therapy caps fight, pushes to reform therapy rule

October 13, 2010

As the end of the year approaches, long-term care providers will be lobbying to extend the therapy caps exceptions process, which is set to end Dec. 31. Another therapy issue—a proposed rule to reduce payments when multiple therapy procedures are provided to a Medicare beneficiary in one day—also is on providers' radar screens.

Doc pay fix temporary resolves nursing home therapy reimbursement rates

June 30, 2010

The recent temporary physician pay fix also decides certain nursing home therapy reimbursement rates.

Obama signs doc pay 'fix,' but bigger cuts could face physicians next year

June 28, 2010

President Obama on Friday signed a law canceling a 21.3% pay cut for Medicare physicians and replacing it with a 2.2% pay increase. The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act is retroactive to June 1.

Association votes to explore new Medicare payment formula as temporary 'doc fix' hangs in balance

June 18, 2010

The American Medical Association voted earlier this week to explore new potential payment systems to replace the current Medicare reimbursement formula, according to an AMA statement.

In test vote, senators reject extending Medicaid assistance to states

June 17, 2010

The Senate said "no" in a key test vote Wednesday to a jobs bill that contains nearly $25 billion in additional Medicaid assistance for states. But the chamber still could pass a scaled-down version of the bill later this week.

House passes bill that delays physician pay cuts, fails to extend Medicaid increase

June 01, 2010

The House Friday adopted a jobs bill that delays for 19 months a 21.2% cut to Medicare physician reimbursements but does not extend a much hoped-for Medicaid increase.