MINNEAPOLIS, January 3, 2008—When President Bush signed the $555 billion omnibus spending bill December 26, physicians were given a reprieve from a 10 percent cut and were given more time to decide about Medicare participation.

The bill temporarily delayed the cut with a 0.5 percent Medicare payment increase for doctors that will expire in six months.

The measure's short timeframe means Congress will have to revisit this issue this spring or else the previously scheduled 10 percent cut will occur July 1.
MMA President James J. Dehen, Jr., M.D., said that obviously, a 0.5 percent increase is better than a 10 percent cut, but once again Congress and the president have failed to fix the problem.

“They keep patching a flawed formula,” Dehen said. “While we are not going to scoff at a pay increase, it doesn't address the problem of the Sustainable Growth Rate (SGR) formula. Congress really needs to focus on fixing this formula.”

Participation deadline extended

The measure also changes the deadline for physicians to declare their Medicare participation or nonparticipation status to Feb. 15. The previous deadline was December 31.
Nationally, the AMA is encouraging physicians to consider their Medicare participation status, given the possibility that the cut may ultimately go through in July.

In most states, physicians have the option of choosing a nonparticipation status that allows them to balance bill patients an additional amount, up to 15 percent, for services in exchange for taking a 5 percent reduction in Medicare reimbursements.

In Minnesota, nonparticipation status for physicians is less financially attractive, since a state law passed in the early 1990s prohibits physicians from balance billing Minnesota Medicare patients more than the set Medicare reimbursement rate. 

Physician Quality Reporting Initiative (PQRI) funded

During July through December 2007, physicians who reported on quality measures included in the PQRI became eligible to receive a bonus of 1.5 percent of their total Medicare allowed charges for that six-month period. The bonus payments will be made as a lump sum payment sometime after February 2008.

The law just passed by Congress extends this program for an additional year. Physicians who participate in the PQRI from January through December 2008 will be eligible to receive a bonus of 1.5 percent of their total Medicare allowed charges for the year 2008 as a lump sum payment sometime after February 2009.
 
SCHIP extended

The bill signed by President Bush also extended the State Children’s Health Insurance Program through March 31, 2009, and provides adequate funding for the states to maintain current enrollment, according to the American Medical Association.
 
Geographic adjustment extended

The compromise would also extend a provision that provides a 5 percent bonus payment to physicians practicing in physician shortage areas through June 30, 2008, and it would extend for six months the work geographic index (GPCI) floor (which results in a nearly 0.5 percent benefit for Minnesota physicians) through June 30, 2008, according to the AMA.