Medicare will delay paying claims for two weeks

Source: theheart.org

Washington, DC - Now that Congress has failed to avert the 21.2% Medicare pay cut scheduled to take effect today, the Centers for Medicare and Medicaid Services (CMS) will try to ease the fiscal pain of physicians by not processing March claims for the first 10 business days of that month, according to a CMS spokesperson.

This move essentially buys time for Congress to postpone the effective date of the massive pay cut. The House passed a 30-day extension Thursday, but Sen Jim Bunning (R-KY) blocked a similar bill in the Senate because the action regarding Medicare reimbursement and other federal programs would have amounted to deficit spending. However, Senate Democrats plan to introduce another bill next week that would delay the effective date for more than 30 days, said a spokesperson for Senate Majority Leader Harry Reid (D-NV). A previous Senate bill allowed for the possibility of a seven-month delay.

Insiders say whatever solution emerges would be retroactive to March 1. That way, CMS carriers would pay March claims that were put on hold at the current rate, although physicians would receive their money later than usual. The alternative—the CMS paying March claims at the slashed rate and then reprocessing them for the full amount after Congress postpones the reimbursement reduction—is more cumbersome.

"We're trying to do everything in our authority to minimize payment disruption to providers and avoid access problems for patients," CMS spokesperson Ellen Griffith said. Organized medicine has warned that if the 21.2% pay cut takes effect, many physicians will stop seeing new and even existing Medicare patients because they won't be able to cover their overhead.

Read more: http://www.theheart.org/article/1051241.do

My insurer negotiations with health care providers all the time for rates lower than I would be charged if I walked in without insurance. My deductible is not affected by that, though.

Doctors refuse to see Medicare patients even now. So one can only imagine what the further cut in payments is going to do.

I have insurance via the state employees plan (as a spouse), which self-insures, and they take that as well.

On edit, for those who are not familiar. People come from all over the world to be treated by these doctors.

"Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle."

Some stores don't take charge cards for similar reasons. Some doctors don't accept ptivate insurance. My dentist requires payment the same day I get treated. And?

This year's yacht will only be 38 meters. The humiliation!

and we are far from wealthy. He has his own practice, with office staff to pay and an office nurse to pay as well as an office mortgage etc. He sees many patients for free who have lost their jobs and we pay for several peoples diagnostic tests and meds our of our own pocket who cannot afford it but NEED it. Painting with a broad brush is always a folly. Yacht my ass.

We were hoping to bring in someone young and help them get started so he could little by little cut back on hours but all the newly minted docs are going to work for the hospital corporations who are paying them a salary. My husband came out of school with a lot of debt in the eighties but it is higher now it seems. It is changing the face of medicine cause when you work for a hospital you lose your autonomy and I think patient care will suffer in the future because of it. My hubby works for himself so he can make house calls and has a lot of flexibility in treating his patients. He still does it old school.

a doctor until it is too late? How about you voluntarily give up 20% of your income starting today?

Are you sure?

I am stating unequivocally that, in fact, if you are to cut the price paid for anything by 20% from one day to the next, you will not be getting the same product or service for long. What product or service do you provide which you can afford to cut the price by 20% and continue operating as if nothing has changed?

I am simply asking what service industry, that you are aware of, can have payment for services cut 20% overnight and still offer the same product or service? Still employ the same amount of staff. Still supply the same product.

Unless of coarse you are suggesting tax incentives for the medical service providers which would offset the 20%..I doubt you are suggesting any such thing judging by your first post in this subthread.

would other persons work less if income taxes are raised?

I am not always popular round here when this subject arises. I believe that most people who are spending money in a business venture...that is, people who are experienced and going to invest in a business which makes financial sense, at least in concept, are going to take into account the tax consequences of their decision. The tax consequences are certainly some of the most important considerations in determining the viability of a business venture. So, yes I do believe that (investors anyway), invest in business less if the tax consequences reduce the projected income to a margin which isn't worth risking the investment money. I don't agree that the subject of the medical industry suddenly receiving 20% less for their services for one class of patients equates to a tax hike, the result is going to be reduction in the level or quality of service due to staffing alone, not to mention supplies and equipment. This will effect the quality of all of our medical care, regardless of our medicare eligibility.

The docs who make the fat cash are generally not the ones billing much to Medicare.

Cartoon assumptions flavored with envy do not lead anywhere good.

this was passed decades ago as part of the SGR... Its been looming for many years, but congress has always passed last minute legislation to defer it until now.

Lot of good it does to have medicare when doctors refuse to take it.

say by offering them a % break on their income taxes.

As more and more boomers become eligible for Medicare, doctors are not going to have a lot of choices. Besides, I have a feeling a good part of this is smoke and mirrors.

The health care center where I get most of my primary care charges a fortune (IN THEORY), even for a visit with a nurse practitior. Then the Center "negotiates" a lower rate than that with my health insurer. Ditto the hospital. And, in both cases, the starting "price" in the negotiations with my insurer is multiples of what they actually charge patients who are uninsured--and I don't mean only those who are hovering around the poverty line, either.

That artifice, however, does not mean any provider loses money treating me. It's like a department store marking up its coats by 100%, just before having a half off sale.

but what happens when an outside entity forces that department store to have a 70% off sale on it's coats? At some point, you stop selling coats.

like a drunken sailor.

still are still in office though they are *now fiscally conservative.














*now = until they regain majority control over all 3 houses then let the party of pork barrel spending start!!!

blue cross took two months to pay my bill.

the doctors and others will get their money.

They'll get their money, but it won't be from medicare.

Hell, rich people paying from their own pocket don't necessarily pay within 2 weeks of an invoice.

about Bunning. But they also tried to put the blame on the democrats for not passing the bill. I think they should be flooded with emails calling them liars and telling them you are posting all over the net how they are trying to be a new 24/7 republican infomerical to rival FOX.

That is the real question.

it keeps getting averted by congress at the last minute. The formula used to reimburse medicare has this cut as part of it, and the democrats were trying to fix it with the health plan rather than pass another short term fix.

yeah right ... :eyes:

Way to hurt older Americans and their caregivers.

A whole thread of repub talking points.

And this has been kicked down the road for decades. Do you deny that?

You could come up with a suggestion as to how to fix it. BTW-yesterday you said HCR cuts Medicare, now all of a sudden it's been going on for decades. ????

Why you refuse to address the people that have been directly affected by this is a mystery.

years. I've been on Medicare for many years now and have switched insurance providers more than once to appease the clinic which consists of perhaps 20 doctors. I feel lucky that I am allowed to still use their facility as they have not pressured me to find another doctor. They have been refusing new Medicare patients for a long time and in one instant I know of a long time Medicare patient who was booted for being "uncooperative"(she was known so be assertive). I am always wondering what new tricks they might have in store to downgrade the Medicare program. I feel my personal doctor is probably relunctantly locked into the policies determined by the owners of the clinic.

not enough in it for her. Do I blame her? Not really.

:kick:

medicare declines a lot fewer claims than private insurance. however, they pay at a lower rate. i guess a doctor who doesn't need any patients over 65 can do without them.

Government-provided malpractice insurance for claims made by Medicare (and possibly Medicaid) patients. If you save the doctors and hospitals the cost of malpractice insurance, you allow them to be able to absorb the cut in fees.

If a doctor took 100% Medicare patients, they might theoretically have zero malpractice insurance costs. But I'd make damned good and sure that this agency kept a good track on those who had more than the normal number of claims.

except it wouldn't be malpractice insurance but a group of restrictions on medicare recipients disallowing malpractice claims/suits. Also, IIRC, geriatric medicine has among the lowest malpractice insurance premiums, I don't know how big of difference it would make.

those classes of medical consumer had something like a Worker's Comp board to go to instead of using the tort system? If it meant faster resolution of claims, and public disclosure about which doctors and hospitals were screwing up the most, wouldn't it be an improvement over a system that takes years, is fraught with doubt, costs millions for expert witnesses, lawyers, court fees, etc. and still protects the guilty with gag orders?

my comment, it sounds as though I advocate taking away entirely their ability to be made whole in case of malpractice, only limitations similar to those imposed on suing the government, it can be done but only under certain circumstances. The board idea may be good. I really don't buy all the hype over the cost of malpractice insurance on the individual level, just the drag on society as a whole. At one time my errors and omissions insurance premium exceeded that of my family friend, family practice physician. My insurance was in a completely non medical field which netted me less money than the good doc made.

I see that to change our health care system isn't going to be a one bill fix. It will require many, many streamlining adjustments.