Physicians who see patients with Medicare will receive a nasty April Fool’s message today, as a 21.3% cut in payments is scheduled to take effect. Congress twice delayed these cuts, and it was expected a longer term fix would be found before Congress left on their spring recess. However, no action was taken and the cuts in the sustained growth rate (SGR) were scheduled to take effect today.

Yet, just a few hours ago, the Centers for Medicare & Medicaid Services, which administers Medicare, told contractors to delay reimbursements to physicians and other health care providers for 10 business days to temporarily avoid the pay cut. 

Before their spring recess, the Senate considered HR 4851, which would have prevented the rate cuts from taking effect, among other actions. But, repeating last month’s objection by Senator Bunning, Republican Senator Tom Coburn from Oklahoma objected to the bill’s consideration on the basis that it should not be considered emergency spending that would be exempt from budgetary offsets. As a result, no vote was taken on the bill.

Senate leaders are planning a cloture vote on April 12 on the debate. If 60 Senators support the cloture motion, a vote on HR 4851 will take place.

California Medical Association President Brennan Cassidy, MD, said the lack of action on these rate cuts was going to have both immediate and longer term effects.

"Doctors are fed up with Congress and its inability to protect health care for senior citizens and provide ongoing stable funding for Medicare," said Cassidy. "It's impossible for physicians to provide their senior patients any certainty if they themselves don't know if they will be able to pay the bills month to month."

J. James Rohack, MD, the President of the American Medical Association, said his organization has long said this payment system would not work and urged Congress to find a long-term solution.

“This year, Congress has dealt with the problem on a month-to-month basis, and now for the second month in a row they failed to act in time,” he said. “This is causing severe instability for seniors and physicians, causing problems for vulnerable patients who rely on Medicare and TRICARE.”

The original SGR formula was passed in 1997. Congress has had to intervene to prevent cuts in physician reimbursement rates, but those have only been temporary fixes.