Providing Stability and Security for Medicare Reimbursements

This memorandum directs the Secretary of Health and Human Services to implement provisions of newly signed H.R. 3962, which replaced a 21.3% Medicare physician fee cut with a 2.2% increase through November 2010. The Secretary must direct Medicare claims contractors to update payment systems, reprocess affected claims automatically, protect beneficiary access, and reopen the Medicare participation enrollment program through July 16, 2010.

Federal Register Open PDF 75 FR 37973

Impact dates

Nov 1, 2010
2.2% physician fee increase expires (statutory, per referenced law)
Jul 16, 2010
2010 Annual Participation Enrollment Program reopened through this date

Key directives

Direct Medicare claims administration contractors to immediately implement physician fee schedule conversion factor update
Provide resources for rapid implementation
Direct automatic reprocessing of claims reflecting 21.3% reduction
Take steps to protect beneficiaries from service disruption during reprocessing
Reopen 2010 Annual Participation Enrollment Program through July 16, 2010

Who is ordered

Secretary of Health and Human Services · Department of Health and Human Services

Timeline

Immediate

Implement legislative update to physician fee schedule conversion factor
Provide resources for rapid implementation
Begin automatic reprocessing of claims with 21.3% reduction

Near term (90d)

Reopen 2010 Annual Participation Enrollment Program through July 16, 2010
Continue reprocessing claims to relieve administrative burden on physician practices

Long term

Temporary 2.2% increase expires November 2010 (per statute, not memo directive)

Risks & tensions

Temporary fix creates November 2010 cliff for physician payments
Automatic reprocessing 'to the extent feasible' leaves implementation flexibility that could create uneven relief
Memorandum explicitly disclaims enforceable rights, limiting legal recourse if directives not followed