Many people thought 2010 would be the year of the permanent Medicare payment fix, that health reform would bring along the end of the flawed sustainable growth rate (SGR) formula. Nope, that just won't be so, says a top industry lobbyist. "If I was a betting man, no, not going to happen," he told me in an off-the-record conversation last week. I can't disclose his name, his organization or even what type of group he represents, but I can tell you he's been sitting in all those secret, behind-closed-doors discussions with top Democrats that you've been hearing about on cable news shows. I wouldn't bet against his bet.

Providers no longer have 15 to 26 months to file Medicare claims. The Patient Protection and Affordable Care Act (PPACA) now requires practices to submit claims within 12 months of the date of service.

So, a claim for any service provided to a Medicare patient in 2010 will need to be submitted one calendar year later. But there are a few wrinkles to keep in mind:

• Claims for services between Oct. 1, 2009, and Dec. 31, 2009, need to be submitted by Dec. 31, 2010.
• Claims for services rendered before Oct. 1, 2009, will follow the previous rules for timely Medicare claims.

Read more on timely claims

I had the opportunity to chat with Rep. Michael Burgess, MD,  for a good 20 minutes yesterday. Dr. Burgess, a self-described "simple country doctor," spent almost 30 years as a practicing OB/GYN in Texas before being elected to the U.S. House of Representatives in 2002. Here's a transcript covering our conversation about the 21% Medicare pay cut hovering on the horizon, and why Congress has dealt with it in fits and starts this year. 

CMS's Average Sales Price (ASP) list is out for the second quarter of 2010 (running from April 1 through June 30). Subscribers can now download an 11-page document on the drug price changes prepared by Part B News.

You'll find it in our Hot Documents folder labeled "ASP_chart_Q210." The document details all price changes from the first to second quater.

CMS contends the prices remain stable. Here's a snapshot of what our analysis has found:

• Prices for 248 drugs will decrease from the amounts paid in the first quarter of 2010;
• Prices for 67 drugs will not change;
• Prices for 270 drugs will increase; and,

Read more on new ASP Part B drugs list

CMS is moving to implement provisions in the the Patient Protection and Affordable Care Act (PPACA). Here's a brief summary of action the agency has taken so far. Look for more news from CMS on the bill over the next few weeks.