With December rapidly approaching, a lame-duck Congress had yet to take action on a Dec. 1 deadline that would cut Medicare and military TRICARE payments to doctors by more than 23 percent, likely forcing many doctors to stop providing services.
According to a Nov. 8 poll published by the American Medical Association, 94 percent of those surveyed want Congress to address the pending funding cuts.
AMA held its “white coat Wednesday” grassroots lobbying campaign on Nov. 17, urging members to call their Congressional representatives and ask them to push back the deadline. That, however, would only defer the problem until a permanent solution is found to lower Medicare payments.
“The constant uncertainty of the (Medicare) program, the risk of audits and the fear of accusations of fraud are strong deterrents to participation,” said Dr. Leah McCormack, president of the Medical Society of the State of New York, in a newsletter to members this month. “Our patients and the general public have little understanding of the problem and little sympathy for the plight of physicians. It is time that we reach out to our patients and the public and give them the facts about Medicare.”
AMA estimates that the cuts will result in some $310 million in lost physician revenue for the care of seniors and disabled residents in Connecticut; in New York, the figure exceeds a whopping $1.6 billion.
After Congress passed a six-month delay of the sustainable growth rate (SGR) formula, the Connecticut chapter of the American College of Physicians asked its members to avoid “drastic changes” in their care for Medicare payments, arguing that would be punishing seniors for “Congressional mischief” in the words of Dr. Robert McLean, governor of ACP”™s state chapter.
At the American Medical Association”™s annual meeting in San Diego this month, AMA President Dr. Cecil Wilson employed similarly strong language.
“The nonchalant way (Congress) dealt with these cuts in the past year played havoc on physicians”™ practices,” Wilson said. “Some physicians had to seek loans to meet payroll and keep their doors open. Many deferred their own compensation. All because Congress dithered and delayed.”
Medicare pays only half the direct costs imposed on physician practices, Wilson added, and the first wave of baby boomers entering the program in 2011 threatens to swamp it. And under the Patient Protection and Affordable Care Act, an Independent Payment Advisory Board is to have the power to make additional cuts in Medicare if it deems the program is exceeding a target growth rate.
“The priority is to eliminate the SGR,” Wilson said. “Toss it overboard. Drown that sucker.”
That is happening even as physicians are in the midst of open enrollment season for Medicare. AMA wants Congress to delay the cut another 13 months, providing sufficient time to craft a permanent overhaul of the Medicare reimbursement system.
According to AMA, one in five physicians say they have been forced to limit the number of Medicare patients in their practice because of the ongoing threat of cuts and the fact that Medicare payment rates were already too low.
