MEDICARE SURVEY Please take five minutes to complete CMA's Medicare survey. ONLINE SURVEY FAX SURVEY Your responses will help us demonstrate to Congress the gravity of the situation and the impact Medicare physician payment cuts are and would have on access to care for California’s seniors.

As most of you know, Congress failed to complete action on the federal budget package. Unfortunately, because of the failure to act, the 4.4 percent cut in Medicare physician payments went into effect on January 1.

Both the House and Senate had passed legislation to avert the cuts. However, the House did not have the votes to pass the final budget because most members had gone home for the holidays. And despite an offer from the House Democrats to allow the physician payment freeze to go forward separately from the budget package, the House Republican leadership held up the bill. Many Republican leaders believe that acting on the Medicare physician payment freeze and other less contentious budget provisions separately from the rest of the package will make it harder for Republicans to advance other controversial budget provisions when Congress reconvenes.

FOR MORE INFORMATION AMA Answers Frequently Asked Questions on Physician Payment Update and Claims Processing Click here for a memo from CMS on the physician payment update and claims processing. Congress Fails to Pass Medicare Payment Freeze by Jan. 1; Physicians Urged to Submit Claims for Billed Charges Until Congress Stops the Cut [Posted 01/05/06] CMA's Medicare Report: "Will Your Doctor Be There?" Click here to download CMA's "Save Medicare" poster. Physicians Mount Grassroots Effort to Halt 26% Medicare Cut [Posted 08/18/05] CMA Develops P4P Guidelines for Medicare and Others [Posted 07/21/05]

The House is scheduled to return on February 1 and will immediately take up the budget bill, which once signed likely would be retroactive to January 1.

In the meantime, physicians are encouraged to submit to Medicare claims for billed charges, rather than billing at 2005 or 2006 fee schedule rates. Only physicians who submit claims for billed charges will be eligible for retroactive payments, once Congress has reimplemented the higher 2005 payment levels.

Physicians will be paid by NHIC, California’s Medicare carrier, at the reduced 2006 rates until Congress returns and passes legislation reimplementing the 2005 fee schedule. If the measure is retroactive, as proposed, NHIC will then make appropriate payment adjustments, including retroactive payments. Physicians will not have to resubmit claims. Physicians who bill at the lower 2006 fee schedule will not receive retroactive payment increases, if indeed Congress returns physician payments to the higher 2005 levels. (Click here for a memo from CMS on this issue.)

Although the 2006 Medicare participation enrollment period is over, CMS has also indicated that it will allow physicians to retroactively change their participation status once Congress has taken action on the physician payment issue.

Physicians, CMA Needs Your Help
Although it looks like the 4.4 percent payment cut will be stopped retroactively, nothing is certain until Congress acts. Stopping the Medicare payment cuts is CMA’s top priority right now and we are aggressively working to get Congress to act as soon as possible. Physicians are encouraged to contact their representatives and urge them to act quickly to stop the Medicare physician payment cut.

To help CMA keep the pressure on Congress, please take five minutes to complete the Medicare survey. Your responses will help us demonstrate to Congress the gravity of the situation and the impact Medicare physician payment cuts are and would have on access to care for California’s seniors. The survey can be completed online or downloaded to be submitted by fax.

Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet.org.