The Senate has been debating what is known as the tax extender bill for the past few days and it looks like they are going to have to cut back on what they initally hoped to achieve. The bill includes a temporary fix to the Medicare SGR, which expired June 1st. Without any sort of extension to the SGR, Medicare reimbursement to physicians will be cut by 21%. Originally, the Senate had hoped to extend the Medicare SGR through 2011, though there is talk that it may only be extended through 2010. If this, in fact, is what passes in the bill; we will be right back here having this same conversation at the end of 2010. I know there is no easy answer. I certainly don’t have the answer, but how many times can Congress temporarily fix Medicare payments?!?!? Physicians are already exhausted as this is the 3rd time this year they have been worried about being cut by 21%. In the meantime, Medicare patients may be thinking they can’t find a doctor to see them because of healthcare reform, which is not the case. Congress needs to decide how to provide a sustainable Medicare reimbursement rate that will allow providers to see patients without continually having to worry of a large impending cut. Now that would be real healthcare reform…….

Similarly, the FMAP bump that has been helping states with the unprecedented growth in Medicaid caseloads may not be extended out in the tax extenders bill. A large number of states created their FY10-11 budget with the expectation that the FMAP bump would be extended to June 2011. Without any additional action by Congress, the FMAP bump will end December 2010. We shall see what the Senate is able to pass….