Here We Go Again… Radiologists Face a 29.1% Cut in Medicare Reimbursement by January 2011

The House and Senate have concluded business and have adjourned to go home to run for re-election. This means several important issues will be carried over to an expected “Lame Duck” session. There is no official start date for this session; however, the “Lame Duck” session could begin as early as the week after the election, but it is more likely that serious discussions won’t start until after Thanksgiving. All of this does not bode well for an SGR fix before the November 30th deadline.

The most significant issue for discussion during the “Lame Duck” session will be addressing the SGR cuts currently scheduled for December 1, 2010. In June, Congress approved a 2.2% increase to avert a 21% pay cut for physicians; however, unless lawmakers intervene again, physician rates are scheduled to decline 23% on December 1, an additional 6.5% in January 2011 and 2.9% more in 2012.

The real solution here is to get ride of the SGR formula, which the Centers for Medicare & Medicaid Services adopted as called for under the Balanced Budget Act of 1997, and replace it with viable solution. Congressional staff has indicated that they still believe that Congress will move to prevent those cuts from occurring, but are most confident of the timing of such a fix. Many are very pessimistic about the prospects for even a short-term fix for the December 1, 2010 deadline.

ADVOCATE will continue to provide up-to-date information on this topic and others as they arise.

With best regards,
Kirk Reinitz, CPA