Get involved: Important Medicare reform info

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UTSouthwestern

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Here is an important message from our organizations' attempts to rectify Medicare issues (This is an exceedingly important legislative effort and it only takes 5-10 minutes to create a letter with the ASA's resources. Please add some type of personal touch to make it a bit more individual, but this is very important for our future):

Per a request from both the ASA and AMA leadership, I'm asking you to contact your senators and representatives about House Resolution 2356 and Senate Bill1081. They both concern medicare payment reform (SGR fix) and the AMA has their website set up such that you can cut and paste a letter together in about 30 seconds from material they have on their website.
Based on your zipcode, they will email the message to your senators and representative.

Our lobbyists for the AMA and ASA tell us that the the leaders in congress continually say that they are not hearing from the physicians. We need to let
our leaders know this is a pending crisis and we the physicians want them to help prevent it from happening.

I have attached copies of the letters I sent below. To send your own letter
and to find out more information about the problem, go to the AMA website
(http://www.ama-assn.org) click AMA agenda and then advocacy efforts. From there click on medicare physician payment reform, and then the action alerts.



Sample letters (customize as you see fit)...

Dear Representative *****,

My name is ***** and I am a resident physician in ****. I stopped by your office and spoke with Sara Williams in May concerning Medicare payment reform. I now request that you support HR 2356.

Critical legislation that would protect patients’ access to care by stopping impending Medicare physician payment cuts has been introduced in the U.S. House of Representatives. HR 2356 seeks to amend title XVIII of the Social Security Act to reform the Medicare physician payment update system through repeal of the sustainable growth rate (SGR) payment update system.

If Congress doesn’t act soon, Medicare will cut reimbursement payments to
physicians by 26% over the next six years—including a 4.3% cut on January
1, 2006.

These Medicare cuts will hurt America’s patients. A recent AMA Member
Connect survey found that 38% of physicians will decrease the number of
new Medicare patients they accept as a result of the first round of cuts in 2006.

For the sake of my patients and profession, these cuts must be stopped.
If not, Medicare payment rates in 2014 will be little more than half what
they were in 1991, after adjusting for practice cost inflation. As it is,
Medicare payments already lag behind increases in practice costs.

Physician payment updates are driven by a flawed formula called the
Sustainable Growth Rate, or SGR. Instead of the SGR, payment updates
should be based on increases in practice costs.

Other Medicare providers are not subject to the SGR. In fact, hospital
payments are slated to rise by more than 3% a year.

Please protect America’s patients and physicians by
cosponsoring HR 2356.

Sample for senate bill...

Dear Senator ****,

My name is ****** and I am a resident physician in Indiana. I
stopped by your office and spoke with your health aide in May concerning
Medicare payment reform. I now request that you support S. 1081.

Critical legislation that would protect patients’ access to care by stopping impending Medicare physician payment cuts has been introduced in the U.S. Senate. The Preserving Patient Access to Physicians Act of 2005 (S. 1081) calls for increasing the amount Medicare reimburses physicians by at least 2.7% in 2006 and 2.6% (est.) in 2007.

Both of the provisions in S. 1081 are based on recommendations of the Medicare Payment Advisory Commission (MedPAC), the commission that advises Congress on Medicare policy.

If Congress doesn’t act soon, Medicare will cut reimbursement payments to
physicians by 26% over the next six years—including a 4.3% cut on January
1, 2006.

These Medicare cuts will hurt America’s patients. A recent AMA Member
Connect survey found that 38% of physicians will decrease the number of
new Medicare patients they accept as a result of the first round of cuts
in 2006.

For the sake of my patients and profession, these cuts must be stopped.
If not, Medicare payment rates in 2014 will be little more than half what
they were in 1991, after adjusting for practice cost inflation. As it is,
Medicare payments already lag behind increases in practice costs.

Physician payment updates are driven by a flawed formula called the
Sustainable Growth Rate, or SGR. Instead of the SGR, payment updates
should be based on increases in practice costs.

Other Medicare providers are not subject to the SGR. In fact, hospital
payments are slated to rise by more than 3% a year ((((This may not be something I would put in your letter as we don't need to court opposition from the Hospital Association which may be receiving positive feedback from Medicare)))).

Please protect America’s patients and physicians by
cosponsoring S. 1081.
 
More information:

I would rather suggest that we highlight the fact that the SGR is flawed
in a number of ways, such as:
(A) It includes the costs of Medicare-covered outpatient drugs and biologicals in setting the expenditure target for physicians’ services,
even though these items are not physicians’ services and therefore,
under the formula, lead to decreases in the annual payment update;
(B) It links Medicare physician fees to the Gross Domestic Product
(GDP) – which does not accurately reflect changes in the cost of caring
for Medicare patients;
(C) Inadequately accounts for changes in the volume of services
provided to Medicare patients due to new preventative screening
benefits, national coverage decisions that increase the demand for
services, a greater reliance upon drugs to treat illnesses, and a
greater awareness of covered health benefits and practices due to
educational outreach efforts; and
(D) It improperly accounts for costs and savings associated
with new technologies and unfunded mandates such as HIPAA
and also point out that the solution to this crisis is to:
(A) Support HR 2356 which would repeal the flawed SGR formula, and
(B) Support replacing the SGR Formula with a system that adequately
accounts for the true costs of delivering healthcare services – The
Medicare Economic Index (MEI)
 
UTSouthwestern said:
Big bump. Just takes 5 minutes to do this. It is really important for everyone to do this, from medical students to board certified physicians.


Done!
 
UTSouthwestern said:
Big bump. Just takes 5 minutes to do this. It is really important for everyone to do this, from medical students to board certified physicians.
Hey UT or even VENT...

is there a way to have this thread put on q forum on SDN. I figure this effects ALL physicians and even if we can get 10-15 ppl on each of the 'subforums' to do this, we'd have a ton of letters.

I guess it would have to some how get cleared with Lee, but I'm sure you guys can arrange that 😉

Thanks!
 
UTSouthwestern said:
Good thought. I don't want to break the rules by cross posting this stuff, but it is a very important topic.

Started a thread for the mod's. I'll see what they say.

Thanks again UT. All these clinical threads are motivating me to study my tail off. Just relearned my vents, capnograms, I:E ratios, peaks, plats, shunt ratios, dead spaces... hahah man I'm rambling.

Oh and I sent letters to Obama, Bush, and Durbin.
 
VentdependenT said:
Oh and I sent letters to Obama, Bush, and Durbin.


aside from Bush, the other two definitely got one from me too! It's time for obama to prove himself to us😉
 
"Access to healthcare for Medicare recipients" is a big topic right now. It's a great thing to include in your letter. We included it in our discussions at the ASA Legislative Conference with everyone we talked to. "Gee, Congressman, we'd like to continue to see your constituents / our patients, but when Medicare doesn't cover our costs, we can't continue to lose money. Your Medicare constituents will have to start going to [insert charity hospital of choice] for their care, because we simply can't afford to accept Medicare patients anymore."
 
though i'm still an MS0, this i feel is of utmost importance. i'll also send out this info to my entering class.

thanks utsouthwestern
 
UTSouthwestern said:
TX, where are you headed? Always interested to see where a fellow Longhorn is going.

hi ut...i'm off to tech (but will always be a longhorn at heart). The biggest challenge is going to be the transition from austin to lubbock (gulp). Other than that i'm looking forward to med school.
 
reply I got from Sen Obama

"Dear Z

Thank you for contacting me with your concern regarding the formula for calculating Medicare physician payments. I appreciate hearing from you and share your concern.

Benefiting over 40 million Americans, Medicare is vital to our essential goal of making health care more accessible to, and affordable for, seniors and disabled Americans. With the premiums for doctor visits and cost of prescription drugs both on the rise, I fear we are losing ground in this regard.

I am concerned with the use of Sustainable Growth Rate (SGR) to calculate physician payments. While SGR was both accepted and encouraged by medical professionals at the time of implementation, it no longer accurately and fairly pays physicians. Physicians will face an estimated 31% reduction in Medicare reimbursement by 2013 if no change is implemented.

Fortunately, provisions within the Medicare Modernization Act prevented such cuts for the past two years, actually increasing payments by 1.5%. We will be doing a tremendous disservice to those who rely on Medicare if this is not corrected. How unfortunate if more physicians must turn away their Medicare patients due to the increasing gap between costs and reimbursements. We must not put our doctors or Medicare beneficiaries in this position. It is imperative that we establish a stable and accurate physician payment formula that reflects the cost of provided care. The Preserving Patient Access to Physicians Act of 2005, S.1081, addresses this issue, and you may be certain of my support for this legislation.

Again, Z, thank you for contacting me. Please stay in touch in the days ahead.


Sincerely,

Barack Obama
United States Senator


P.S. Our system does not allow direct response to this email. However, if you would like to contact me again, please use the form on the website
:


looks like he's with us!!
 
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