Wednesday, December 19, 2007

Medicare patients face possibility of drastic changes in their medical care

For those that may be wondering why this blog has given so much attention lately to the universal healthcare plans adopted by the state of Massachusetts and the California legislature, it is because these programs have a devastating effect on our medical care, especially for seniors.

We are facing the most serious blow to what many in this country believe is the best medical care in the world being inflicted upon us by mostly liberal politicians and some Republicans in elective office that either do not take time to analyze the programs or are swayed by the news media clamor to "do something about our out of control health costs” regardless of the adverse impact current proposals have on the availability and quality of healthcare in the United States.

One of the most damaging changes already set to come into effect January 1, 2008 is the further cut-back in reimbursement to physicians by Medicare for services rendered to Medicare patients. Unless congress acts quickly, there will be a further average pay cut of 10.1% for all doctors who care for Medicare patients (in addition to pay cuts of previous years), although the percentage will vary by specialty, practice and geography. As American Medical Association Board of Trustees Chairman Dr. Edward L. Langston said: "Next year's 10.1% physician payment cut is bad news for America's seniors as 60% of physicians say the cut will force them to limit the number of new Medicare patients they can treat." Many seniors on Medicare will likely see their doctors refuse them service because of the cuts in Medicare reimbursements.

The 2008 Medicare pay cut for doctors is twice as large as the 5% cut physicians avoided this year because Congress declined to adjust the payment formula. That decision made this year's payment reduction less but it also meant that the 2008 cut would have to be two times as high to get reimbursement back in line with the level called for in the Medicare formula.

With congressional debate on reducing the upcoming 10.1% Medicare cut to physicians going into the final weeks of the year, physicians' decisions on whether to participate in the program in 2008 take on added importance. The year-end deadline for physicians to change their participation status is important because it likely will determine how doctors will be able to bill the program and receive payment for all of 2008. If physicians do not inform their Medicare carriers in writing of their intent to change their status before January 1, they will be locked into their current choices for the next 12 months.

Dr. Ron Davis, AMA president, said "Unless Congress takes immediate action ... Medicare will begin across-the-board cuts on January 1. Congressional action is not guaranteed, so physicians interested in changing their Medicare participation status for 2008 should do so before December 31.”

One option some physicians may elect is known as private contracting. By choosing this option physicians opt out of Medicare completely for at least two years. During that time, neither they nor their patients can bill Medicare for any of their services. This will be a further problem for seniors because most cannot afford medical care without Medicare assistance and those keeping doctors who opt out of Medicare will be charged very high fees for simple office visits.

Some in congress did recognize problems resulting from the Medicare cut and the Senate wrote language to alleviate the burden on doctors but unfortunately politics reared its ugly head and the language was inserted into the SCHIP legislation which President Bush vowed to veto for unrelated reasons. The House is still working on the issue.

Everyone is urged to contact their Senators and Congressmen to demand a stand-alone bill that addresses the looming problem for Medicare patients without muddling the bill with political issues that only serve to distract from the real problem facing seniors on Medicare. The timing is very crucial; the current mandated Medicare reimbursement cuts must be addressed in the remainder of this year to preclude taking effect on January 1.

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