Congress Blocks Medicare Pay Cut

Wed January 02, 2013

(Washington, DC) - Last night, Congress cleared legislation postponing automatic spending cuts and blocking a 27% cut in Medicare payments to psychiatrists and other physicians. With respect to healthcare, among other provisions, the budget package:

• Blocks the 27% reduction in the update to Medicare payments to physicians and other health professionals for one year, until December 31, 2013; Extends Geographic Work Adjustment (1.0 floor) through Dec 31, 2013;
• Temporarily blocks a 2% across-the-board sequestration cut in Medicare payments and all other health-related programs including healthcare research;
• Includes language to improve the provision of relevant and timely data to physicians needed in new delivery and payment;
• Allows physicians to participate in clinical registries to meet Medicare quality reporting requirements;
• Reauthorizes the National Quality Forum for one year;
• Officially repeals the previously defunded CLASS community living program; and,
• Establishes a Commission on Long-Term Care.

In order to help pay for the one-year SGR physician payment “patch”, the package also:

• Rebases payments to disproportionate share (DSH) hospitals (saves $4.2 billion);
• Recoups additional “code creep” payments to hospitals (saves $10 billion); and,
• Reduces risk adjustment payments to Medicare Advantage plans (saves $2 billion).

APA continues to work with the AMA and with other medical specialties to find a permanent solution to the SGR payment formula. Please visit our Physician Reimbursement and Practice section to learn more about APA's advocacy efforts.

Join APA