May 22, 2012

Congress Passes Ten-Month Extension of Doc-Fix

February 17, 2012, Congress passed the Middle Class Tax Relief and Job Creation Act of 2012. The legislation includes a ten-month extension to a Medicare physician pay freeze. Without the extension, the sustainable growth rate formula would have required a 27% cut to Medicare physician pay as of March 1.

The U.S. House of Representatives Ways and Means Committee released a summaryof the legislation, noting that the ten-month doc fix will be paid for with a 65% decrease in Medicare bad debt reimbursements to hospitals and skilled nursing facilities beginning in FY 2013 for those providers currently reimbursed at 70% as well as a phase-in of the 65% reduction over the next three years for those providers who are currently reimbursed at 100% of their bad debt (e.g., FQHCs and dialysis centers). In addition to the reduction of bad debt reimbursement, the legislation also reduces clinical laboratory services payment rates by 2% in 2013 and cuts Medicaid disproportionate share hospital (DSH) allotments.

This ten-month extension follows a two-month extension approved by Congress in December 2011. The Medical Group Management Association reports that physicians now face the threat of a 35% Medicare payment reduction in 2013.

©2012 von Briesen & Roper, s.c

About the Author

Chair of the Litigation and Risk Management Practice Group

Heidi is a Shareholder and Chair of the Litigation and Risk Management Practice Group. Her practice focuses on insurance coverage litigation, commercial disputes, constitutional law, construction disputes, environmental litigation, and complex litigation.

Heidi lectures on a wide variety of topics including environmental insurance coverage, environmental issues, bad faith litigation, motor carrier issues, and advertising injury liability/personal injury liability coverage.

She is a member of the American and Milwaukee Bar Association, the State Bar of Wisconsin, the Defense...

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