Medicare Cuts will go into effect...now what?

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interleukin2

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From Medscape Medical News

Senate Rejects "Doc Fix," Medicare Fees Cut 21%

Mark Crane
Authors and Disclosures
Physician Rating:
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June 17, 2010 — In a last-minute shock to physicians, the Senate voted today against postponing a scheduled 21% reduction in Medicare reimbursement to physicians and other health providers.
A compromise proposed by Sen. Max Baucus (D-MT) was defeated largely along party lines, with no Republican support. The compromise was put forward after the Senate had rejected a $140 billion finance package yesterday that would have delayed the cut in Medicare payments to physicians until 2012, along with measures to extend unemployment benefits and provide $24 billion to states to cope with their Medicaid programs.
The lower-spending compromise bill, dropping the total cost to $118 billion and the overall deficit impact from $79 billion to $55 billion, would have delayed the planned Medicare cuts and provided a 2.2% raise for physicians through November 30, rather than for the 19 months mandated by the earlier bill.
It still was not enough, however, to win over the 60 senators needed to end debate on the issue under Senate rules. Fifty-six senators voted in favor, with 40 opposed. Opponents argued that the overall measure was not offset by spending cuts and added too much to the deficit.
The pay cut for physicians took effect June 1, but the Center for Medicare and Medicaid Services (CMS) had held up June claims through today, anticipating that Congress would stop the reduction retroactively.
Because the "doc fix" was defeated, CMS is ready to authorize its contractors to begin paying physicians at the lower rate.
"Senate Fiddles as Medicare Burns"
The American Medical Association (AMA) warned that unless Congress restores the cuts, physicians will limit the number of Medicare patients they treat. A survey of 9000 members revealed that 17% of physicians — and 31% of those in primary care — would take such action because Medicare rates are too low.
Just before the vote, when the 6-month fix was still seen as viable, the AMA condemned it, saying that Congress has broken its promise to America's seniors and military families. In a news release titled, "Senate Fiddles as Medicare Burns," AMA President Cecil B. Wilson, MD, noted that Congress has been arguing about the "doc fix" for months.
"Delaying the problem is not a solution," Dr. Wilson said in the statement. "Continued short-term actions are creating severe instability that harms seniors as physicians make decisions to protect their practices from Medicare's volatility. Continuing down this path just slaps a Band-Aid on a problem that needs urgent surgery."

Article: http://www.ama-assn.org/ama/pub/news/news/senate-fiddles-medicare-burns.shtml

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Medicare is a doomed program. The politicians can argue all day long, but regardless its a doomed program. Medicaid is even worse. This is the beginning of the end people... the beginning of the end. Our country now has 2 classes of people, the producers, and the moochers. And we're sitting at about 50/50. So tough times are ahead as the moochers continue to demand more and more from those of us that actually produce.
 
Questions ...

1. Is this official this time??? No more push backs, freezes, etc?

2. Correct me if I'm wrong, but every physician who is not 100% forced to accept Medicare will no longer take it? Right? Isn't this going to really, really hurt said population?

3. Aren't all private insurances going to follow suit and drop their reimbursements through the floor?

4. Since this is a huge blow to Medicare patients, is this the first step in a long line of being forced to see a certain amount of Medicare patients to renew license?
 
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Questions ...

1. Is this official this time??? No more push backs, freezes, etc?

2. Correct me if I'm wrong, but every physician who is not 100% forced to accept Medicare will no longer take it? Right? Isn't this going to really, really hurt said population?

3. Aren't all private insurances going to follow suit and drop their reimbursements through the floor?

4. Since this is a huge blow to Medicare patients, is this the first step in a long line of being forced to see a certain amount of Medicare patients to renew license?

1. I just looked around, I couldn't find any evidence that this has definitely happened. Doesn't mean it hasn't, just that I can't find proof.

2. I think most will still take at least some Medicare patients. I like to think most of us are good people who will still try and help some of these patients. I expect practices to stop taking new Medicare patients certainly, but not kicking out the ones they have until it becomes financially necessary.

3. There's a good chance of that.

4. Possibly, though that depends on location I suspect. Mass. has already started something like that. I don't see many Southern states jumping on this idea.
 
I'm thinking of doing a fellowship year just so I can move to Australia and practice (should say "practise").

Galt's Gulch is looking better and better.
 
I'm thinking of doing a fellowship year just so I can move to Australia and practice (should say "practise").

Galt's Gulch is looking better and better.

Told you so my friend....
2win
 
Thunderdome!!
 
According to Senatus, the Senate passed another 6 month temporary fix today.
 
Google News has the same info from the AP. I think this was a stand-alone bill which maybe paved the way for passage. The fix that got rejected yesterday was wrapped in a jobs bill with an unemployment extension and some other stuff.

+1

I believe they tried wrapping it up in the jobs bill bc last fall they tried to pass a permanent fix but republicans painted it as adding to the cost of Obamacare and not making it 'deficit neutral.'

Now the new plan didn't work. So we're back to temporary fixes.

I like that it's a 6 months fix. You know, just past election time.
 
Problem is the house bill does not match the bill the senate passed. House cannot act until next week. The cuts are in effect. If the house passes the fix next week, docs will have to resubmit their claims from early June to get paid.


I want the cuts to go through then docs will finally start dumping these patients and maybe people will see how lousy the system is.
 
4. Possibly, though that depends on location I suspect. Mass. has already started something like that. I don't see many Southern states jumping on this idea.

This measure was attempted but defeated in MA. I don't know by how much, however, or how likely it is to be attempted again. I should specify that it wasn't that physicians would've been forced to treat medicare patients, but rather state-aid patients (subtle difference).
 
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Links of Interest




Today, the U.S. Senate passed by unanimous consent a free-standing bill that averts the pending 21 percent payment cut and provides physicians a 2.2 percent Medicare update effective June 1 and extending through November 30.

This action follows weeks of failed negotiations seeking to find agreement on an amendment to H.R. 4213, "The American Jobs and Closing Tax Loopholes Act" that would address the SGR issue. After failing to find consensus on the jobs and tax bill, the Senate leadership extracted the SGR issue for standalone consideration.

House consideration and passage of the new bill, technically a modified version of H.R. 3962, is still required. With the House adjourned for the week, consideration is not expected until Tuesday, June 22.

Immediately following Senate passage of the "fix," CMS released information informing lawmakers that carriers have been directed to process claims for services provided on June 1 and later with the 21 percent cut. CMS is expected to provide retroactive relief for these claims once a payment fix is enacted into law. The agency announced it is "prepared to act expeditiously to make the appropriate changes to Medicare claims processing systems."


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New Jersey Physician Supervision Legislation Moves Forward

The New Jersey Assembly Regulated Professions Committee voted in support of legislation that would codify existing New Jersey regulations that require physician supervision of nurse anesthetists in the hospital, ambulatory surgical center, and office setting. Ervin Moss, M.D., Executive Medical Director, New Jersey State Society of Anesthesiologists (NJSSA) provided testimony in support of A-2268. He was joined at the table by Rex Ponnudurai, M.D., NJSSA President and John Fanburg, Esq. The Medical Society of New Jersey provided a statement of support.

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A copy of A-2268 can be found here. Dr. Moss's June 10th testimony can be found here.


Congratulations to Drs. Moss and Ponnudurai and NJSSA members for this recent win!


Iowa Board of Medicine Adopts Interventional Pain Regulations

The Iowa Board of Medicine ("board") adopted rules that define interventional chronic pain management as the practice of medicine. ASA orchestrated a successful call-to-action among Scope of Practice Partnership members and other pain associations. Last year, the board issued a draft policy statement on this issue, but the board changed direction earlier this year and issued proposed rules. The Iowa Society of Anesthesiologists and the Iowa Medical Society testified at multiple board meetings concerning this issue. The rules must be reviewed and approved by the legislature's Administrative Rules Review Committee in order to take effect. A copy of the proposed rules can be found here.


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I want the cuts to go through then docs will finally start dumping these patients and maybe people will see how lousy the system is.

When that happens it'll take our incompetent, partisan, lazy, worthless, ignorant, loser representatives in Congress about 63 seconds to unanimously pass a law making it illegal for physicians to refuse government insurance.

Can't have those rich greedy doctors murdering the innocent poor with their selfish neglect, you know.


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Ah, yes, can't go strolling through Bartertown without Fido. I've got that covered ... sort of. 140 pounds of rottweiler doofus. More doofus than guard dog, but he looks scary.

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