Congress Passes Part B Fee Schedule Legislation

VHCA (4/16/2010)

Late Thursday evening, Congress passed and President Obama signed a Medicare physician payment bill that extends the 2009 Part B physician fee schedule through May 31 – reinstating the payment rate that was in place on March 31.  This will allow the Centers for Medicare & Medicaid Services (CMS) to rescind a 21.2 percent reduction that went into effect on April 1 because of the sustainable growth rate, or SGR, formula. The Medicare Part B physician fee schedule is very important to post-acute providers as it determines the reimbursement rates for the Part B covered therapy services provided by nursing facilities. 

The House approved a Medicare extension bill on March 17 that would have extended the Medicare payment rate through the end of April.  However, the Senate failed to pass the legislation before adjourning for a two-week recess on March 26, permitting the 21 percent pay cut to take effect on April 1.  CMS held payment of claims from April 1-15, awaiting passage of the payment legislation. The Senate, however, was unable to pass the Medicare payment bill before the 21.2 percent cut started to take effect.

Lawmakers soon will take up legislation to extend the current payment rates through October 31, 2010.  Both the House and Senate have passed separate bills to accomplish this extension and are now negotiating details related to the funding of the measure.