ICA NEWS RELEASE
International Chiropractors Association
January 3, 2008
2008 MEDICARE FEE CUTS POSTPONED
AT LAST MINUTE
In the closing hours of the 2007 Congressional session, the US House of Representatives and the US Senate acted on the same day to suspend for six months the pending 10 percent Medicare physician fee cuts scheduled to go into effect on January 1st. On December 19th, both Houses of Congress voted to adopt S.2499, legislation that included the six-month suspension. That legislation was signed by the President on December 29, 2007, leaving the Medicare carriers only 48 hours to revise the fee schedules before the first of the year, an impossible deadline given the complexity of the tasks of revising fee schedules and altering billing computer software to address the 11th hour change.
The last-minute Congressional action also increased general doctors Medicare fees by an additional 0.5 percent, and extended a number of other higher reimbursement rates, such as those to rural health care providers. The postponement is only for six months, and thus the scheduled 10 percent cut will automatically go into effect on July 1st unless Congress acts again to postpone the otherwise mandated fee reduction.
Some carriers acted quickly to make the necessary amendments. Others are still in the process of implementing the amended fee schedule. “ICA has been in touch with the Centers for Medicare and Medicaid Services (CMS) as well as a sampling of regional carriers and it appears that this confused situation will not be quickly resolved,” said ICA Medicare Committee Chairman Dr. Michael Hulsebus. “Each regional carrier will need to alter their claims processing programs and post the new fee schedules, a process which will likely take a week or more in some instances.”
The fee change is inherently more problematic for the non-participating provider, since the question of what the practice should charge and collect from the patient is uncertain. Practices that have started to charge the reduced fees posted before the Congress acted will perhaps be obliged to re-file those claims and address the collection of the additional portion of the restored fee level from patients. ICA urges all members to contact their regional carrier directly and follow the directions they provide on fees and billing procedures.
Under Medicare’s controversial Sustainable Growth Rate (SGR) formula, cuts in physician payments are mandated and automatic whenever growth in these expenditures outstrips growth in Gross Domestic Product. In previous years, as was done in the closing days of 2007, Congress acted at the last minute to postpone such mandated cuts. In addition to the temporarily postponed 2008 cut, physician fees are scheduled to be reduced by another 5 percent on January 1, 2009, based on the same SRG formula, all at a time when the federal Medicare Payment Advisory Committee has recommended that Congress increase payment rates by 1.7 percent in 2008 in line with the estimated practice cost increase.
ICA will keep members informed of developments on this important issue. Please see ICA’s website at www.chiropractic.org for breaking news on this and other topics.
