'Extenders' Bill Passes House; Medicare Cuts To Take Effect Today

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On Friday, the House approved the so-called "extenders" bill (HR 4213), which would extend a series of expiring unemployment and tax benefits and delay until 2012 a 21% cut to physicians' Medicare payments, CQ Today reports.

However, the Senate left for the weeklong Memorial Day recess, which means that the unemployment benefits will expire and the 21% cut to Medicare physician payment rates will take effect on Tuesday.

The House approved the bill in two phases: first, with a 215-204 vote to approve the package of extensions to the tax and jobless benefits and then with a 245-171 vote to delay the physician payment cut (Rubin, CQ Today, 5/28).

New Version

Last week, the House Democratic leadership agreed to eliminate about $31 billion from the $145 billion bill to secure enough votes for its passage before members left for the recess. Under the new version of the bill:

Extensions of COBRA subsidies for unemployed workers and a renewal of additional state Medicaid funding outlined in the 2009 federal economic stimulus package would be eliminated (California Healthline, 5/28); and

Physicians' Medicare payment rates would be increased by 2.2% for the remainder of 2010 and by 1% in 2011, before the payment formula would revert to the current formula in 2012 (California Healthline, 5/27).

The Congressional Budget Office estimated that the final version of the bill still would add $54.2 billion to the federal deficit. Although CBO projected total outlays of $102 billion, the "true cost" of the package actually approaches $113 billion when all of the revenue-raising offsets in the bill are combined with the emergency spending and exemptions that would raise the deficit.

Next Steps

The Senate likely will amend the bill when it reconvenes on June 7 -- after the weeklong recess -- to address members' concerns with the bill's provisions, cost and deficit projections. If the Senate makes any changes to the legislation, it would have to go back to the House for a revote.

According to CQ Today, Congress eventually might extend most of the expiring provisions retroactively (CQ Today, 5/28).

CMS To Briefly Delay Payment Cuts

In an attempt to offset the start of the 21% cut to Medicare physician payment rates, CMS last week sent letters to health care providers informing them that the agency has instructed Medicare contractors to delay processing medical claims for 10 business days.

CMS contractors on June 14 will begin to process claims for physician services that were performed on June 1, the day the 21% payment cut takes effect (Ethridge, CQ Today, 5/28).

Physicians, Seniors Groups Express Anger

Advocates for elderly U.S. residents and representatives of physician groups expressed anger with the Senate for failing to act on the extenders legislation before members adjourned for the recess, Roll Call reports.

  • American Medical Association: AMA President J. James Rohack on Friday in a blog post wrote, "Congress is wreaking havoc on the Medicare program and physician practices across the country." He also said in a statement that the groups' "grass-roots and patient networks are fully engaged and we'll be getting the word out to the media as well."
  • American Academy of Family Physicians: AAFP President Lori Heim said the group's members are "pretty furious" that lawmakers had not completed work on the legislation. Heim said that AAFP had called for longer-term resolution and that the group would not support the current proposal to delay the 21% cut until 2012 (Roth, Roll Call, 5/29).
  • American College of Cardiology: ACC CEO Jack Lewin called the Senate's failure to act "the worst-case scenario" for patients and physicians (Ethridge, CQ Today, 5/28).

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