Medicare Payments Frozen for Another Year

One day after the official deadline, the U.S. Congress yesterday stepped away from the so-called "fiscal cliff" and slapped another one-year patch on physicians' Medicare payments.

The 13th-hour deal averts the 26.5-percent cut in Medicare payments that was scheduled to take effect on Tuesday by freezing the current rates for 2013. It finances the $25 billion cost of the freeze with a package of cuts in Medicare payments to hospitals, pharmacies, and end-stage renal disease treatment.

The final pact also postpones the additional 2-percent Medicare cut that was part of automatic, across-the-board cuts in federal spending. The bill delays all of those cuts for two months as lawmakers and President Obama look for agreement on a broader fiscal package.

In addition, increased Medicaid payments for primary care services were preserved, as requested by the Texas Medical Association and other state and national medical societies. The geographic work adjustment (1.0 floor) was extended through Dec. 31, 2013. However, payments for advanced imaging services will be reduced based on a change in assumptions regarding the utilization of equipment. 

Missing from the agreement is organized medicine's top priority: repeal of the Sustainable Growth Rate (SGR) formula that forces the annual crisis in payments for Texas physicians who care for 2.8 million Medicare patients and more than 870,000 military families who receive coverage through TRICARE.

"It is simply irresponsible of Congress to push Medicare patients, their physicians, and the nation's economic future into dire chaos," said TMA President Michael E. Speer, MD. "Our nation's leaders must put politics aside and work on real issues to move our country forward – instead of pushing us downward into a spiraling free fall."


 Action Special Issue, Jan. 2, 2013 


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