*NEW* Medicare Physician Pay to Remain at Same Rate, Cuts Delayed

As in previous years, a delay to the planned 2010 Medicare physician payment cut has been delayed. Under the Sustainable Growth Rate formula (SGR), a 21.2 percent cut would have gone into effect on January 1. CAFP is one of the many organizations urging Congress to scrap the SGR altogether and come up with a more representative way to address growth. Congress now has an additional two months to explore options.  Your Academy will keep you informed as this issue moves forward. More information is available here.

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CAFP continually advocates for fair payment and reduced administrative complexities in both the Medicare and Medi-Cal programs.  Most recently we have worked with the Centers for Medicare and Medicaid Services on Part B administrative carrier transition issues.  In addition, we continue to promote appropriate payment for Medi-Cal services through all available avenues - legislative, regulatory, and judicial.  The last was accomplished by the recent lawsuit to prevent the 10 percent cut to Medi-Cal provider payments.

Activities Related to Palmetto Transition

CAFP has taken a number of actions to ensure family physicians are treated fairly in the transition process.  In addition to hosting a teleconference to connect interested practices directly with Palmetto provider relations staff, we worked directly with CMS officials and senior Palmetto staff to address casework concerns.  We've also worked closely with California Congressional delegation staff to solve outstanding problems and concerns.  Due to the high volume of payment delays experienced by Academy members, we formally requested that Congress initiate a Government Accountability Office (GAO) report into transition issues.  We also worked with Congresswoman Ellen Tauscher's office in their efforts to formally request a Congressional investigation into this matter.  CAFP members who continue to have Palmetto payment delay issues may contact CAFP's director of health policy, Sandra Newman, at snewman@familydocs.org.

Medicare Carrier Advisory Committee Actions
The Medicare Carrier Advisory Committee meets twice per year in order to receive input on local coverage decisions and inform providers of relevant policy and procedural updates.  The most recent meeting for the J1 region (California, Nevada and Hawaii) was held on March 18.  Providers should be aware that as of January 1, 2009, a new Advanced Beneficiary Notice (ABN) should be used.  Palmetto has advised that any old ABN forms should be destroyed.

Practice Management News
The following recent editions of Practice Management News have addressed Medicare payment issues:

New Year, New Codes, New Billing Opportunities - January 2009 (HTML | PDF)
Frustrated with California's New Medicare Contractor? - October 2008 (HTML | PDF)
Answers to Frequently Asked Coding Questions - August 2008 (HTML | PDF)
Good News for the Virtual Office Visit: Health Plans are Beginning to Pay! - May 2008  (HTML | PDF)
2008 Coding and Billing Updates and Changes - February 2008 (HTML | PDF)
Coding and Billing: Answers to Your FAQs - March 2007 (HTML | PDF)