Doctors seeking $200M owed by Medicare

Doctors are asking the Medicare agency to quickly explain how it will dole out $200 million in overdue reimbursements following “a highly disruptive year" for physician payments.

Healthcare reform enacted this year called on the Centers for Medicare and Medicaid Services (CMS) to reimburse doctors retroactively to Jan. 1, 2010, on several provisions, including extending the floor for a Medicare payment scale used to determine relative costs of practicing medicine in specific locations. Some states were set to receive significant increases due to changes in the scale, according to the Friday letter signed by more than 100 physicians groups.

The Medicare and Medicaid Extenders Act of 2010, which provided a one-year delay in a scheduled cut to Medicare physician rates, included $200 million to process the payment increases, the letter said.

The letter said uncertainty surrounding Medicare physician payments was disruptive to doctor practices. Congress enacted stopgap measures to delay scheduled cuts to Medicare payments several times this year, and on three occasions, temporary cuts went into effect.

“The payment uncertainties and delays were highly disruptive,” the letter said. “Many practices were forced to seek loans to meet payroll expenses, lay off staff or cancel capital improvements and investments in electronic health records and other technology.”

Further, the final 2010 fee schedule undervalued some cardiology codes due to a CMS calculation error, the letter said. Most of the claims have not been adjusted, and some were 40 percent lower than they should have been, the letter said.