Medicare Cuts Kick In; Take Action Today Apr 15. 2010 | Comments (0)
The April 14 deadline came and went with no action from the U.S. Congress, so the 21.3-percent cut in physicians' Medicare payments officially took effect today (April 15).
"It is absolutely unacceptable for the United States Congress to inflict this kind of perpetual uncertainty on Medicare patients and their physicians," said Texas Medical Association President William H. Fleming III, MD. "This is an all-too-real reason why Congress needs to quit dithering and get to work on a permanent new Medicare payment formula today.
"We need every physician, every patient, every nurse, every spouse, and every health care professional in Texas to join our million-signature petition drive now."
The American Medical Association released a statement saying that "some carriers have the capacity to hold claims for an additional day or two and still meet Medicare law’s prompt payment requirements, others will begin processing claims today at the reduced rates. Importantly, claims for services provided on or after April 1 will not be processed all at once; rather, they will be processed on a rolling basis, with claims for services provided earliest completed first and later claims held for as long as possible. We fully expect that retroactive payment adjustments will be made for claims processed at the reduced rate."
At presstime, TMA was unable to obtain clear guidance from TrailBlazer Health Enterprises, Texas' Medicare carrier, explaining exactly what it intended to do.
The fee cut has been in effect since April 1 when Congress went on its spring recess. The Centers for Medicare & Medicaid Services (CMS) ordered TrailBlazer and other Medicare carriers to hold all claims for services provided on or after April 1 for 10 working days until April 14 to minimize administrative complications and other disruptions that would result from calculating payments based on a fee cut that Congress was expected to overturn.
April's Medicare Meltdown led TMA and Texas county medical societies to lead a national grassroots campaign of physicians and patients calling for a stable new Medicare payment formula.
As of mid-April, more than 35,000 signatures were on TMA's online petition asking Congress for a permanent fix to Medicare's Sustainable Growth Rate (SGR) formula and to preserve senior citizens' access to care. Fifty-one state medical associations and 14 national specialty societies are promoting the petition that urges Congress to "Stop the Medicare Meltdown" and develop "a rational Medicare physician payment system that automatically keeps up with the cost of running a practice and is backed by a fair, stable funding formula."
Please add your name to the petition and encourage your friends, family, colleagues, staff, and patients to sign it, as well.
The need for a stable Medicare system is illustrated by the political maneuvering in the U.S. Senate. As this issue of Action was prepared, the Senate was considering a House-approved bill, HR 4851, which delays the 21.3-percent cut in payments to physicians until May 1. Sen. Max Baucus (D-Mont.), chair of the Senate Finance Committee, offered an amendment to postpone the cut until June 1. However, a final Senate vote on passage of HR 4851 awaited an agreement between Democrats and Republicans. If approved, it would be the third time since late December that Congress has voted to delay, rather than eliminate, the fee cut.
TMA and Texas county medical societies launched the petition drive during a series of news conferences across the state on April 5. Within days, all 50 state medical societies, plus the District of Columbia, and more than 15 specialty societies joined the Stop the Medicare Meltdown petition drive.
"It shows how strongly patients and physicians feel about their relationship," Dr. Fleming said. "For a Medicare patient, a doctor can mean everything: independence, hope, and security. And, physicians want to be available to our Medicare patients – we don't want to be forced out of Medicare.
Each year Congress slaps a temporary Band-Aid on the problem, postponing a steep cut to a later date.
"This ongoing uncertainty hurts patients and their doctors. Patients need to know their doctor will be there when they need them," added Dr. Fleming.
"We need more than Band-Aids," Dr. Fleming said in TMA's open letter to Congress. "We need more than sutures. We need a complete transplant. This is all about Medicare patients' access to physicians' care. Congress created this problem, and only Congress can fix it." He noted that he and other physicians desperately want to continue to take care of their Medicare patients – that's why they became doctors.
"Our seniors, patients with disabilities, and military families deserve better than the on-again/off-again health plan Medicare has become," TMA President-Elect Susan R. Bailey, MD, said at an event in Fort Worth. "The only acceptable solution is for Congress to repeal the flawed Medicare formula and replace it with a stable, fair funding mechanism that reflects the true cost of providing care."