Congress, White House agree on one-year fix on scheduled fee cut

Physicians, mental health professionals, and other Medicare providers feared gridlock in Washington given the impending change in leadership in the House of Representatives. But Congressional leaders have managed to iron out a year-long agreement, avoiding a reimbursement cut that could have lopped off as much as 29.5% of treatment fees.

The fee cut is on the table every year, but is always averted by Congress at the eleventh hour. It looked to be a bigger threat in the year gone by because the fix for 2010 wasn’t finalized until June, after which payments were updated retroactively.

That fix was only good through December 1 of 2010, and provider advocates worried that the lame duck Congress would leave it for the new leadership to grapple with. Instead, the new fix passed, and will run through 2011.

“That’s the good news,” says Laura Groshong, director of government relations for the Clinical Social Work Association (CWA). “We do need to have a permanent change for this problem, but this is better than going month-to-month, as we were.”

There’s still a fly in the ointment, however. Medicare officials announced that they will be updating their provider list and will require all eligible providers–psychiatrists, psychologists, and CSWs–to re-enroll.

“They’re trying to get a cleaner system,” explains Groshong. “Some of the people on their rolls weren’t actually providing services anymore. And they want people to move to electronic claims.”

The original deadline to reapply was in January of 2011, Groshong says, but it looks like that will be extended again.

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