October 24, 2021

Volume XI, Number 297

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October 22, 2021

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Medicare Physician Payments

In a prior blog, we discussed the CMS report regarding the projected solvency of the Medicare Program.  As we previously reported, CMS has projected the solvency of Medicare through 2024.  However, a reading of the report shows that to accomplish this goal, payments to physicians as of January 1, 2012 need to be reduced by approximately 30%, and Medicare would need to follow the current statutory requirements of reducing payments to all other providers, resulting at some point with those providers receiving less than Medicaid.  Since the issuance of a CMS report, an analysis has been conducted by the Congressional Budget Office (CBO) which confirms that portion of the CMS Report dealing with the necessity for a reduction in physician compensation.

Since 2012 is a federal election year (for the President, Senate and House members), it is highly likely that a stop gap measure will be enacted and signed into law, kicking the can down the road, to January 1, 2013, after the election.  From the provider point of view, this Damocles sword presented by the threat of reduced future payments from the Medicare program (whether the providers are physicians or non-physician providers) clouds the ability of the providers to commit resources to their current practice.  Providers may be reluctant to bring on additional employees, whether physicians or other employees, to otherwise expand their practices, or to acquire practices.

Even the delay of implementation of a physician payment reduction until January 1, 2013, while it will provide relief during the election year of 2012, is not a solution to the problem.

© 2021 Giordano, Halleran & Ciesla, P.C. All Rights Reserved National Law Review, Volume I, Number 179
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About this Author

Frank R. Ciesla, Giordano Law Firm Health Care Litigation Health Care Fraud and Abuse Tax Health & Hospital Law
Of Counsel

Mr. Ciesla is Chair Emeritus of the firm's Health Care Law Practice Area. His practice is primarily devoted to Health Care and Government Contracts Law. He counsels clients on legal developments facing healthcare providers in the modern health care environment. Firm clients include hospitals, nursing homes, physicians and physician groups, individual practice associations, home health agencies, ambulance carriers and industry-wide associations.

Mr. Ciesla advises such clients on business structures, mergers and consolidations, joint ventures, reorganization of health care providers...

732-741-3900
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