The Takeaway: With Congress Home For The Holidays, Docs Face Steep Medicare Pay Cut

Medicare Cuts Could Hit Jan. 18: In a few weeks, physicians, therapists and nurse practitioners could see a steep cut in their Medicare reimbursement rates-almost 30 percent. Experts thought Congress would pass a temporary 'doc fix' to stop this from happening, like in years past. But with the end of 2011 fast approaching-and lawmakers already having left Washington for the holidays-that's looking like less and less of a possibility.

Here's the deal: If Congress doesn't pass a payroll tax cut extension bill by Jan. 1, payroll taxes will go up for 160 million workers, almost 2 million people could lose unemployment benefits and doctors could see a 27.4 percent pay cut from Medicare. On Saturday, the U.S. Senate passed a bipartisan (and Obama-approved) two-month measure-in addition to extending the payroll tax cut, it contained a provision waiving the scheduled cut in physicians' Medicare pay-kicked it to the House of Representatives, then went home for the holidays.

But the House rejected the measure yesterday. The (mostly Republican) caucus voting against it said they hope to work out a full-year renewal of the payroll tax cut, not just a two-month stopgap measure. Which sounds sort of reasonable, right? Until you consider that Congress must pass such a bill before Jan. 1, the House's rejection kicks the bill back to the Senate, and Senators have already left D.C.!

So where does this leave us? No one's quite sure.

Medicare told doctors it will hold claims for the first 10 business days of 2012, to see if Congress acts early in the new year. During a similar standoff in 2010, Medicare was able to hold physician claims for more than 20 days, but Medicare deputy administrator Jonathan Blum told The Associated Press that the system can't hold off that long again, because a backlog of more than a couple of weeks could cause Medicare's computers to crash. "(Medicare) came very close operationally to crashing our system back in 2010," Blum said . "From a stewardship perspective, that is something we feel we can never repeat again."

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