Monday, June 14, 2010


[Please scroll down for update]

As we've mentioned before, proponents of ObamaCare© planned to try a little sleight of hand with the numbers:

"In order to avoid "adding one dime to the deficit", Obamacare ... had to play shell games with the funding. One way was to cut pay to doctors who treat Medicare patients by 21%.

In doing so they stripped billions out of the cost of Obamacare by projecting a $200 billion savings ... The game plan was to add those billions back in via a separate bill termed "doc fix

Of course, this "savings" was anything but, since the trick was to just add those dollars back in under a different budget line. The assumption was that there would be no actual cut. But we all know what happens when we "assume:"

"President Barack Obama is asking Republican lawmakers to approve billions of dollars in new spending to avert a scheduled 21 percent cut in payments to doctors who treat Medicare patients."

It's interesting that, as usual, PresBo is attempting to make this a Republican problem; last time I looked, it was his party that controls congress (and its purse strings). In other words, he decided to play chicken with the lives of some of our most vulnerable citizens, and then blinked.

On the one hand, the folks pushing ObamaCare© want us to believe that it will add nothing to the (record breaking) deficit, while on the other doing nothing to actually control costs. The result is that they failed to plan for the very real possibility (now reality) that their little legerdemain would fall flat. Faced with mind-boggling debt, responsible legislators simply put up the stop sign.

It's true that both parties have played this game before, but it's also true that the stakes have never been this high. That's what you get, one supposes, when "you have to pass it to see what's in it."

UPDATE: In the comments, Bob mentions that he "was under the impression the Medicare cut went into effect 6/1 when Congress went home rather than voting another extension. The doc fix was supposed to be part of the COBRA subsidy and unemployment benefits package."

Great point, so I asked our resident Guru, guest-blogger and Medical Office Manager Kelley Beloff for an explanation:

On June 1st the extension of 2009 fee schedule ended and the 2010 fee schedule, with a 21% percent cut went into effect. However, CMS suspended processing all claims for 10 business days, that is until June 15th, in the hope that Congress would again, for the third time this year, extend the 2009 fee schedule. For example, it was extended on January 15 to April 1. Congress did not extend in time to stop the April 1st deadline and CMS held all claims the first 10 business days in April. At the last minute, the extension was passed for June 1 and now we are in the same situation we were in on the first of January and again on April 1 of this year. At this time, it does not look promising that the bill will pass. If it does not pass, then CMS will process all claims from June 1 on based on the reduced 2010 fee schedule. My revenue cycle has been a roller coaster this year; I cannot count on revenue coming in in a timely manner."
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