BALTIMORE — CMS finalized its 2010 physician fee schedule
on Oct. 30, and 21.2 percent payment cuts are firmly in place.
Unless relief comes in the form of a "doc fix," physicians will feel
the pain. However, if the powerful American Medical Association
earns doctors a reprieve, home care advocates fear that could put
HME on the chopping block once again as lawmakers look to make up
the revenue shortfall.
Immediately following finalization of the 2010 payment rule, the
president of the AMA issued a strongly worded condemnation of what
he deemed the "whopping" cut.
"Permanent repeal of the payment formula is an essential element
of comprehensive reform to improve the health system for patients
and physicians," said J. James Rohack, MD, president of the AMA.
"Security and stability for America's seniors will not be achieved
without a permanent solution to the broken Medicare physician
payment formula. The U.S. House of Representatives will soon vote
on legislation (H.R. 3961) to permanently repeal the current
Medicare physician payment formula, and Congress must fulfill their
existing obligation to America's seniors as they work to create new
commitments to the American people through health reform."
Congress has previously headed off any physician cuts through
temporary fixes. In mid-October, however, Sen. Debbie Stabenow,
D-Mich., proposed a bill in the Senate (S. 1776) that would amount
to a "freeze" that would repeal the current Medicare physician
payment system at a cost of about $247 billion over 10 years. That
bill, however, failed to move to a vote.
The Senate Finance Committee health reform bill (S. 1796) would
raise doctor's payments by 0.5 percent in 2010.
Michael Reinemer, vice president of communications and policy
for the American Association for Homecare, said the doc fix may end
up waiting in line behind health care reform, but he acknowledges
that it is difficult to say at this point.
"The reality is that until there is a permanent fix, which is
going to have a big price tag, it is an annual threat to the HME
sector simply because they have to scramble and find money in a
budget-neutral, or pay-as-you-go, environment," Reinemer said. "So
to pay for the doc fix, they must find Medicare cuts, and that puts
us at risk even though our reimbursement has been cut over and
over."
Judging by the strong words of Rohack, it's clear that
physicians will not acquiesce to the cut without a serious
fight.
"Medicare's final 2010 payment rule confirms that in 60 days,
physicians face steep cuts of 21.2 percent — the largest
payment cut since Congress adopted the fatally flawed Medicare
physician payment formula," added Rohack. "Access to care and
choice of physician for seniors, baby boomers and military families
is at serious risk — and Congress must fix the payment
formula once and for all this year."
Like last year, the clock is running on the physician pay cut,
which is scheduled to take effect on Jan. 1, 2010. According to the
AMA Web site, the 21 percent cut will grow to approximately 40
percent by 2016.
"Persistent, looming cuts and low payments reduce access to care
and keep physicians from participating in quality initiatives and
purchasing health information technology," the AMA said. "Medicare
payments should cover the increasing cost of providing care so that
seniors can be assured of continued access to physician care."
