July 16, 2008

The suspense is over. The Medicare Improvement for Patients and Providers Act of 2008, H.R. 6331, has become law, and anesthesiologists and others will benefit from the following changes:

1. 2008 physician payment: instead of cutting payments for physician services by 10.6% on July 1st, Medicare will leave the conversion factors unchanged.
2. 2009 physician payment: instead of dropping another 5.4 percent next year, the Medicare conversion factors will increase by 1.1 percent in January.
3. Discriminatory teaching rule: teaching anesthesiologists—like teaching surgeons—supervising two concurrent resident cases will receive full payment for each beginning in 2010. The 50 percent reduction for concurrent anesthesia resident cases will be history.
4. The bonus for successful reporting under the Physician Quality Improvement Initiative (PQRI) will rise from 1.5 percent to 2 percent of Medicare allowed charges in 209 and 2010. 

We began writing this message to you yesterday morning, when President Bush followed through on his promise to veto the bill. Before we could complete the text, the House of Representatives had overridden the presidential veto by a vote of 383-41. Then, early Tuesday evening, as we were beginning to draft an appeal to contact your Senators again to make sure that the legislation passed, the Senate also voted to override the veto, 70-26.

July 15th would have been the earliest date on which Medicare could have started paying claims at the lower rate had there been no legislative fix. Now your claims should continue to be paid correctly at the same conversion factor levels as during the first half of 2008 (Column A in the table below). If any of your Medicare payments appear to be calculated using the CFs that would have gone into effect if H.R. 6331 had not passed (Column B), the Medicare carrier is supposed to reprocess the claims automatically. If that doesn’t happen, you should resubmit the claim. ABC clients can rely on their account managers to make sure that they receive the correct payments.

We salute ASA and the MGMA for their roles in the passage of H.R. 6331 and we congratulate ASA for its long-overdue success in ending Medicare’s discriminatory treatment of teaching anesthesiologists.