The Senate is now working on the tax extenders bill, which contains the patch to the already-live 21.3% Medicare fee cut. As COA related, the House basically split this bill in two pieces, and passed both before the Memorial Day recess. The Senate now has basically put the bills back together, and is considering amendments to it.

Currently, the bill the Senate is working on contains a 19-month patch to the sustainable growth rate (SGR), with increases retroactive to June 1st of 2.2% through the remainder of 2010 and a 1% increase in 2011. In 2012, there would be a payment cut of an estimated 33-35%.

The Senate is actually considering increasing the patch to 2014. This would especially placate the White House, which does not want to face this situation in the year before the 2012 elections. This is potentially good news because the longer extension is more of a relief.

The bad news is that the Senate will not likely vote on this bill until early next week, according to the current plan. The bill would then have to go back to the House for a vote, and then to the President to sign into law. This time schedule would mean that CMS would have to start paying claims from June 1st till next Tuesday, June 15th, which is the end of the current 10 business day hold on claims. Payment would reflect the 21.3% payment cut on physician-related services. We would anticipate that when and if the bill is passed, CMS would reprocess claims paid at the lesser amounts.

Based on the many requests that COA receives for updates, we are once again alerting you to what may likely happen. We note that although the Senate Democratic leadership believes the 60 votes are there to move and pass this bill, anything can happen. The bill currently adds $140 billion to the federal deficit, and this may increase to $200+ billion if a longer-term SGR patch is included along with other provisions.

Finally, we note that the House had trouble passing one bill that was significantly less than this Senate version. House Blue Dogs objected to the cost, which led to reducing the size of the bill and breaking it into two bills. So, until the dust clears in the Senate of exactly what is in the Senate bill and how much it costs, it is unclear if the bill can pass the House. Unfortunately, Congress is playing politics with the lives of Medicare seniors, as well as your practices and livelihoods. Even if this SGR situation gets addressed at some point, payment cuts to cancer care will continue until the cancer community tells Congress and the President to Stop Cancer Care Cuts.

COA is working on this and providing updates to keep you informed. We are also informing Congress about the crisis unfolding in cancer care, which is why we invite all to Capitol Hill on June 23rd. Unless community oncology engages, it will lose to other areas of medicine very active in this issue.