Yesterday, as expected, President Bush vetoed the Medicare bill containing the physician payment cut restoration--and both the House and Senate overrode the veto within hours of his action. The House vote was 383 to 41; in the Senate it was 70 to 26. In his veto message, Bush said he objected to the bill because it would get its funding from a reduction in federal payments to Medicare Advantage.
As a result of the bill's passage, the mid-year 2008 Medicare Physician Fee Schedule (MPFS) rate of -10.6 percent has been replaced with a 0.5 percent update, retroactive to July 1, 2008. Physicians, nonphysician practitioners, and other providers of services paid under the MPFS should begin to receive payment at the 0.5 percent update rates in approximately 10 business days or less. Medicare contractors are currently working to update their payment system with the new rates.
In addition to setting aside the 10.6 percent cut in Medicare payments to physicians that took effect on July 1, the bill also:
* Extends the effective date of the exceptions process to the therapy caps to December 31, 2009; outpatient therapy service providers may now resume submitting claims with the KX modifier for therapy services that exceed the cap furnished on or after July 1, 2008.
* Terminates durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding contracts awarded under round 1 of the program and restarts the bidding and contracting process in those areas in 2009. The bidding process for round 2 will begin in 2011. Payment adjustments for DMEPOS in noncompetitive bid areas will not take effect until round 2 is completed.
* Exempts rural areas and metropolitan statistical areas with a population of less than 250,000 from competitive bidding for at least five years.
* Eliminates the Medicare Advantage adjustment for indirect medical education payments.
* Gives pharmacies that are located in, or that provide services to, long-term care facilities no less than 30 days and no more than 90 days to submit their claims for reimbursement to the drug plans.
* Requires Part D drug plans to pay pharmacies within 14 days for properly completed claims that are filed electronically, and within 30 days for claims submitted otherwise.
* Requires the Secretary of Health and Human Services to modernize the dialysis payment system by implementing a fully bundled payment system for end-stage renal disease, effective Jan. 1, 2011.
Access the bill summary.
