It appears that almost no Part B claims wound up being processed at the reduced rate of -21%, even though Medicare contractors were technically supposed to begin processing claims at the lower rate on April 15. They had about one eight-hour business day to do so before Congress passed a pay-fix bill that reverses the cut effective to April 1 and lasting until May 31.

An amendment tacked on to a bill containing the 30-day doc fix would further delay the 21% cut to physician payments until June 1. The amendment passed the Senate by a 60-40 vote Wednesday, but the entire bill is still awaiting final passage.

Today, April 15, marks the day carriers will start processing Part B claims at reduced rates. The 21% cut was implemented April 1, but CMS demanded carriers hold Medicare claims for 10 business days -- thus buying Congress time to adopt a pay fix. 

Senate Majority Leader Harry Reid (D-Nev.) said Thursday morning he hoped to pass the bill by the close of business. The bill would then need to go back to the House of Representatives for approval before going to the president to be signed into law.

Read more on the Medicare pay fix

Associations representing physicians and medical groups aren't happy with Congress at the moment. Groups have blasted Congress for allowing Medicare claims to be processed at the 21% reduced rate today. Here's a round-up of what's been said:

American College of Physicians (ACP)

"If Medicare begins paying physician claims with the 21% reduction starting on April 15, any short-term fix that might be legislated this weekend or later - even though retroactive - likely will create a cash-flow problem in the meantime with claims being paid at the lower rate," Joseph Stubbs, MD, ACP president said. "This will send an unfortunate message to Medicare beneficiaries."

"There's the additional wrinkle that doctors may have to go back and re-bill patients for higher co-insurance once the payments are restored retroactively," Dr. Stubbs concluded. "If Congress then applies some short-term fix - be it for six weeks or six months - the added cost of rebilling will just add to the chaos."

Read more on Medicare pay cut

I managed to catch up with the AMA's incoming president, Cecil B. Wilson, as the good doctor (he's a longtime internist) was waiting in an Atlanta airport for a flight to Chicago. He was very generous with his time and offered some rather candid commentary -- in my opinion -- on the state of the pay fix.

For instance, when I asked him about Democrats' political sensitivity to the $240 billion price tag for a pay fix, Dr. Wilson replied, "They're not alone in that, the Republicans have said they're not going to vote for anything that increases the deficit as well ... I think the Republicans have an agenda as well, which is to oppose whatever this administration is suggesting." This post contains a full transcript of our conversation.

You can expect the 21% cut to Medicare reimbursements will be a hot topic in the news this week. Congress has until April 14 to prevent claims from being processed at the reduced rate. Here's a round-up of recent Medicare-related news coverage in the press:

The Fresno Bee reports local physicians are worried the Medicare pay cut is going to go through.

The Wall Street Journal outlines basic Medicare changes in the new health care reform law.

The Hill reports White House Budget Director Peter Orszag thinks health care reform will realize more savings than what's projected in Congressional Budget Office studies.

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