Hi Paul:
It's the Congress vs. President Bush and we're all stuck in the middle. I don't think that they will continue the pay cut after June- if they do, it'll really kill off Medicare as we know it as large numbers of physicians will stop accepting new patients and may opt to cut out old patients altogether.
What they've done as a compromise, though, is to disenfranchise the Pay for Performance (P4P/PQRI) initiatives which were going to be a real big pain in the rear for all of us. They used that money to pay for the 10% pay cut fix. It is really incredible that they did this, and in this manner. Bush had threatened to veto the measure if it didn't have a EHR component tied to the final legislation (note that by not dismembering it completely, they avoided the Bush veto; defunding it, though, was OK it seemed). Would you REALLY be happy had you been given the 10% pay cut, but only IF you close down your non-CCHIT certified AC and have to buy a GE or NextGen EHR in order to see Medicare patients? THAT was what we were looking at- like looking down the wrong end of the Medicare shotgun barrel.
As probably the biggest, loudest, banned from emrupdate because of this issue lowly physician lobbyist I'm more-than-delighted with the bill the way it's come out. The only negative is the 6-month issue, but it'll get fixed. THIS IS A BIG WIN FOR ALL OF US!!!
Here's where the actual complete bill language resides:
http://www.govtrack.us/congress/billtext.xpd?bill=s110-2499Note that at first it looks like they established monies for the PQRI (Physician Assistance and Quality Initiative Fund)here, including the eventual almost-5-billion a year earmarked for the future:
"`(i) IN GENERAL- Subject to clause (ii), there shall be available to the Fund the following amounts:
`(I) For expenditures during 2008, an amount equal to $150,500,000.
`(II) For expenditures during 2009, an amount equal to $24,500,000.
`(III) For expenditures during 2013, an amount equal to $4,960,000,000."
But then they seem to have taken it away, at least for now:
"(C) TRANSFER OF FUNDS TO PART B TRUST FUND- Amounts that would have been available to the Physician Assistance and Quality Initiative Fund under section 1848(l)(2) of the Social Security Act (42 U.S.C. 1395w-4(l)(2)) for payment with respect to physicians' services furnished prior to January 1, 2013, but for the amendments made by subparagraph (A), shall be deposited into, and made available for expenditures from, the Federal Supplementary Medical Insurance Trust Fund under section 1841 of such Act (42 U.S.C. 1395t)."
Whatever we end up with, you have until 2/15/2008 to make up your mind whether to stay a participating provider or not. I'd give the process a chance to finish, though, before becoming a NONPART provider just yet.
