Directory
Industry Insights
Medicare & Medicaid Extensions in the Temporary Payroll Tax Cut Extension Bill
By: Eddie Marmouget
Eddie Marmouget
National Industry Partner
Consulting
Health Care
Springfield
417.865.8701
The president signed the Temporary Payroll Tax Cut Continuation Act of 2011 on December 23, 2011, extending the payroll tax cut provisions for two months. The bill also contains important extensions to certain Medicare payment provisions for two months through February 29, 2012. These extensions include:
- The Medicare physician payment update, or “Doc Fix,” which delays the 27.4 percent reduction to Medicare fee schedule reimbursement and leaves the fee schedule unchanged for the two months ending February 29, 2012
- Section 508 wage index reclassifications, extended from September 30, 2011, to November 30, 2011 (These cuts will not be budget-neutral, and the Centers for Medicare & Medicaid Services (CMS) must make additional payments by December 31, 2012.)
- Medicare outpatient hold-harmless payments, including payments for sole community hospitals
- The Work Geographic Adjustment Floor for computing physician payments
- Exceptions process for Medicare therapy caps
- Payment for technical component of certain physician pathology services
- Urban, rural, “super rural” and air ambulance add-on payments
- Physician fee schedule mental health add-on
- Minimum bone mass measurement payments
- The Qualifying Individual program
- The Transitional Medical Assistance
It is also important to note there were no Medicare cuts contained in this bill. However, the stage is set for a congressional battle on extending and paying for the payroll tax cut. The House bill supported by Republicans, HR 3630, is still alive, and Senate Democrats have agreed to conference on this bill. HR 3630 includes these significant provider cuts:
- Eliminating provider-based reimbursement on evaluation and management codes
- Reducing Medicare bad debt reimbursement
- Eliminating Medicare outpatient hold-harmless payments
- Extending therapy caps to hospital-based departments
- Rebasing Medicaid Disproportionate Share reimbursement in 2021
- Eliminating other extensions discussed above
If enacted, these cuts would be steep for many health care providers.
For more information, contact your BKD advisor.
Directory
Subscribe