Impending Medicare Reimbursement Cut Effective 2013
This letter was sent from ACEP President Dr. Andrew Sama to all ACEP members.
Dec. 20, 2012
As you know, without congressional intervention, current federal law dictates Medicare physician reimbursement rates will be cut by nearly 27% on January 1, 2013.
The general consensus among key policymakers is that any deal reached between President Barack Obama (D) and House Speaker John Boehner (R-OH) regarding a plan to avert the impending “fiscal cliff” (expiration of tax cuts and steep cuts in domestic spending set to take effect at the beginning of January) would have contained another short-term fix for Medicare reimbursements.
However, with no imminent agreement in sight and time running out, it appears increasingly likely that efforts to avert the 27% cut will not occur before Congress adjourns at the end of the year.
According to a statement released Wednesday, the Centers for Medicare & Medicaid Services (CMS) is taking steps to implement the negative physician payment update, which means claims filed beginning January 1 will be paid at the reduced reimbursement level.
Federal law dictates that CMS cannot pay Medicare claims sooner than 14 calendar days for clean electronic claims after the date of receipt and 29 days for paper claims. Given the mandatory delay in claims processing, there will be a very small window of opportunity for Congress to act before the first reimbursements of the year are processed.
ACEP urges our members to be prepared to contend with the lower Medicare reimbursement levels, at least initially next year.
Emergency medicine leaders and ACEP staff continue to urge the House, Senate and Administration to repeal the fundamentally flawed Medicare reimbursement formula for physicians and replace it with a model that provides stability and consistency for physicians.
ACEP knows the challenges you face, and we will continue to speak out with a strong and unified voice on the issues like this that matter most to you and your patients.