SGR fix remains in limbo

The looming 27.4% cut to Medicare physician reimbursement is now imminent following a House vote today not to approve a Senate-amended version of the Middle Class Tax Relief and Job Creation Act.

Instead of voting on the bipartisan compromise Senate bill that included a two-month fix for the sustainable growth rate (SGR) formula, the House passed a resolution requesting that the two chambers meet to work out the differences in a congressional conference committee. However, the Senate has already adjourned for the holiday recess, setting the stage for the scheduled cuts to become effective as scheduled on January 1.

It's unclear whether the Senate will come back to rectify the differences in the bill prior to the State of the Union address on January 24, according to the American College of Radiology (ACR).

With the situation still unsettled, the U.S. Centers for Medicare and Medicaid Services (CMS) has instructed its claims contractors to withhold physician payment claims for the first 10 business days of 2012. This decision will minimally affect provider cash flow because clean electronic claims are not paid sooner than 14 calendars days (29 days for paper claims) after the date of receipt under current law, the ACR said.

Further information is scheduled to be released by CMS on or before January 11.

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