Breaking News: House Passes Amended Version HR 4213

This afternoon, the U.S. House passed an amended version of  HR 4213 – “The American Jobs and Closing Tax Loopholes Act of 2010,” which includes Sustainable Growth Rate (SGR) provisions such as:

  • A suspension of the Medicare physician payment cuts produced by the Sustainable Growth Rate (SGR) formula for 19 months;
  • A 2.2 percent Medicare physician payment update for the remainder of 2010;
  • A one (1) percent update for 2011; and
  • A return to the current SGR formula in 2012—which will result in an estimated 33 percent cut that year.

The SGR provisions were voted on separately from the rest of the legislation, passing on a bipartisan vote of 245 to 171. To see how your Representative voted, visit

No Action by Senate Before June 7

Because the Senate is adjourning without considering the bill, the 21 percent Medicare physician payment cut scheduled for 2010, which has been postponed three times already, will technically take effect on June 1. The Centers for Medicare & Medicaid Services already issued instructions to its contractors to postpone processing claims for Medicare physician services provided on or after June 1 for 10 days to provide time for Congress to complete its action and overturn the scheduled cut retroactive to June 1.

The latest revisions reflect a reduction in the overall price tag for the bill, addressing concerns expressed by the members of the Blue Dog Coalition, who objected to federal deficit increases that would have been produced by previous versions of the bill. Costly provisions that were reportedly dropped from the bill last night include extensions of COBRA benefits for the unemployed and FMAP (Medicaid) funding increases to the states.

In a statement released last night, AMA President J. James Rohack, MD, says “the Senate has turned its back on seniors, and America’s physicians are outraged that Congress has deserted patients by failing to address this year’s Medicare cut before the June 1 deadline.” Read Dr. Rohack’s complete statement

Physicians:  Let Congress Know It’s Time to Act

NCMS members are encourage to contact Congress to explain how its mismanagement of the Medicare program is wreaking havoc on their practices.  Use the grassroots hotline at 1-800-833-6354 or visit

Be sure to sign the online Stop the Medicare Meltdown petition, which is being led by the Texas Medical Association (TMA) and jointly supported by the NCMS and other state medical societies. TMA plans to present the petition to Congress following the holiday recess. You can also ask patients to sign the petition (download a flyer for patients).


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