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Physicians Seeing Fewer Medicare Patients Because of Low Pay and Threat of Cut
Robert Lowes
Authors and Disclosures
June 3, 2010 — The failure of Congress to permanently solve the Medicare reimbursement crisis is making it harder for seniors to make an appointment with a physician, according to a new survey by the American Medical Association (AMA).
The online survey of 9000 physicians in May revealed that 17% — and 31% of those in primary care — are limiting the number of Medicare patients they treat, with most of them explaining that Medicare rates are too low and that the threat of future cuts "makes Medicare an unreliable payer," in the words of the survey.
The AMA released the survey today in tandem with the debut of an ad campaign urging Americans to pressure the Senate to address Medicare reimbursement when it convenes next Monday after a week-long Memorial Day break.
Last Friday, the House passed a Democrat-sponsored bill that would postpone a scheduled 21.3% reduction in Medicare reimbursement from June 1 to January 1, 2012, and give physicians small raises in the meantime. However, Senate Democrats opted not to try to pass the legislation in their chamber that day, saying they did not have enough time to do so before the Memorial Day break. Instead, senators began flying home that Friday.
Senate Democrats have a harder time passing legislation than their House counterparts because Senate Republicans command the 41 votes needed to sustain a bill-blocking filibuster, which is not permitted in the House.
As a result of Senate inaction, the draconian pay cut took effect on Tuesday, June 1, although the Center for Medicare and Medicaid Services is holding June claims for the first 10 business days of the month, or through June 14, in the hope that Congress will avert the reduction retroactively.
The cut was triggered by the sustainable growth rate (SGR) formula that Medicare uses to set physician reimbursement. The formula sets an annual target for Medicare spending on physician services based partly on growth in the gross domestic product. If actual spending exceeds the target, Medicare is supposed to decrease physician reimbursement the following year to recoup the difference. Every time Congress postpones a cut — an annual practice since 2003 — the difference between targeted and actual spending accumulates, translating into bigger and bigger cuts.
This year's reduction was set to take effect on January 1, but Congress put off the effective date until March 1, then April 1, and then June 1. It missed the deadline to avert the cuts set for March 1 and April 1, and had to retroactively undo them.
Permanent Fix Still Needed, Says AMA
Although the AMA and other major medical societies want Congress to rectify the most recent cut before June 14, they do not favor a solution along the lines of last week's House legislation, which would postpone the cut for several months or years. Such solutions, they argue, only subject physicians to even deeper cuts when a temporary "doc fix," as lawmakers call it, expires. For example, physicians would face a 33% rate reduction on January 1, 2012, under the House bill. Instead, organized medicine has urged Congress to repeal the SGR formula and replace it with something more equitable for medical practices...........
By the time I get around to practicing, the accumulated cuts will be like 90%. Damn the government, they better their **** together.
Robert Lowes
Authors and Disclosures
June 3, 2010 — The failure of Congress to permanently solve the Medicare reimbursement crisis is making it harder for seniors to make an appointment with a physician, according to a new survey by the American Medical Association (AMA).
The online survey of 9000 physicians in May revealed that 17% — and 31% of those in primary care — are limiting the number of Medicare patients they treat, with most of them explaining that Medicare rates are too low and that the threat of future cuts "makes Medicare an unreliable payer," in the words of the survey.
The AMA released the survey today in tandem with the debut of an ad campaign urging Americans to pressure the Senate to address Medicare reimbursement when it convenes next Monday after a week-long Memorial Day break.
Last Friday, the House passed a Democrat-sponsored bill that would postpone a scheduled 21.3% reduction in Medicare reimbursement from June 1 to January 1, 2012, and give physicians small raises in the meantime. However, Senate Democrats opted not to try to pass the legislation in their chamber that day, saying they did not have enough time to do so before the Memorial Day break. Instead, senators began flying home that Friday.
Senate Democrats have a harder time passing legislation than their House counterparts because Senate Republicans command the 41 votes needed to sustain a bill-blocking filibuster, which is not permitted in the House.
As a result of Senate inaction, the draconian pay cut took effect on Tuesday, June 1, although the Center for Medicare and Medicaid Services is holding June claims for the first 10 business days of the month, or through June 14, in the hope that Congress will avert the reduction retroactively.
The cut was triggered by the sustainable growth rate (SGR) formula that Medicare uses to set physician reimbursement. The formula sets an annual target for Medicare spending on physician services based partly on growth in the gross domestic product. If actual spending exceeds the target, Medicare is supposed to decrease physician reimbursement the following year to recoup the difference. Every time Congress postpones a cut — an annual practice since 2003 — the difference between targeted and actual spending accumulates, translating into bigger and bigger cuts.
This year's reduction was set to take effect on January 1, but Congress put off the effective date until March 1, then April 1, and then June 1. It missed the deadline to avert the cuts set for March 1 and April 1, and had to retroactively undo them.
Permanent Fix Still Needed, Says AMA
Although the AMA and other major medical societies want Congress to rectify the most recent cut before June 14, they do not favor a solution along the lines of last week's House legislation, which would postpone the cut for several months or years. Such solutions, they argue, only subject physicians to even deeper cuts when a temporary "doc fix," as lawmakers call it, expires. For example, physicians would face a 33% rate reduction on January 1, 2012, under the House bill. Instead, organized medicine has urged Congress to repeal the SGR formula and replace it with something more equitable for medical practices...........
By the time I get around to practicing, the accumulated cuts will be like 90%. Damn the government, they better their **** together.
