Wednesday, January 16, 2019

Medicare reimbursement for physicians will be cut by 2 percent on April 1

With no solution on the horizon to the budgetary woes in Congress, physicians should prepare for a 2 percent reduction in reimbursement from the Medicare program beginning on April 1.

The 2 percent Medicare “sequestration” cuts are part of the $1.2 trillion in cuts required by the Sequestration Transparency Act, part of a deal worked out to end last year’s debt-ceiling crisis. Under the act, across-the-board cuts will be triggered if Congress fails to come to an agreement on how to reduce the federal deficit. The cuts are evenly split between defense spending and discretionary domestic spending. Medicaid is exempt from the cuts.

The mandatory Medicare cuts will result in a savings of $11 billion in 2013.

The biggest of the sequestration cuts will hit the Department of Defense, which will lose almost $55 billion. Education will lose 100 percent of the $38 billion in annual grants it gives to states. Total cuts for 2013 will be $109 billion.

Although it is possible that Congress will eventually come to an agreement and reverse some of these cuts, physicians should prepare for the possibility of a 2 percent cut to their Medicare claims.

The California Medical Association (CMA) is vigorously fighting the Medicare cuts. CMA leaders were in Washington, D.C., mid-February urging the California Congressional delegation to stop these cuts. We will keep fighting.

While implementation is scheduled for April 1, 2013, the actual impact may not be felt for several weeks, while Centers for Medicare & Medicaid Services implements the necessary changes.

For more information, see “Sequestration FAQ: How will the cuts affect California physicians?” This FAQ, available in CMA’s online resource library at www.cmanet.org/resource-library, answers the most commonly asked questions about the sequestration cuts as they relate to health care. This document will be regularly updated as additional details become available.

Contact: CMA’s reimbursement helpline, (888) 401-5911 or economicservices@cmanet.org.


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