Automatic Physician Fee Cut Will Rise to Almost 30% in 2012

The automatic Medicare physicians fee cut, which would go into effect if Congress did not come through with another physician fee fix, would rise to 29.5 percent on Jan. 1, 2012, according to a CMS letter to MedPAC.

The Hill reported that the new figure is higher than the 28.3 percent rate used in President Obama's proposed budget to calculate the cost of a proposed two-year fee fix. That would mean the $62 billion allocated for that fee fix would be several billion dollars short, according to The Hill.

For the same reason, the 10-year cost of repealing the sustainable growth rate formula, used to calculate Medicare physician fees, would likely be significantly higher than the $369.8 billion estimated in the president's budget.

In December, Congress passed a one-year fee-fix that averted a 25 percent reimbursement cut for physicians.

Because Congress has not altered the sustainable growth rate, the percent increase of the automatic fee cut rises each year. While Congress has allowed the fee cut to go into effect for periods of a few days each, it has always come through with a temporary fee fix, ranging from as little as a month to a full year.

MedPAC asked CMS for the figure to compile its annual payment report to Congress, due on March 15.

Read the HHS letter on the physician fee fix (pdf).

Read more coverage of recent proposals and implementations of Medicare physician fee fixes:

- Proposed Two-Year Fee-Fix Faces Funding Challenges

- Upcoming Fee Fix Would Mean Squeezing Hospital, Physician Payments

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