Medicare Docs in a ‘Fix’

WASHINGTON — Last week a coalition of physician groups
again called on legislators to put together a new Medicare payment
system for doctors. Under the current formula, if Congress doesn’t
act to stop reimbursement cuts scheduled for Jan. 1, 2012, the docs
are looking at a 29.5 percent pay cut, according to CMS.

In his 2012 budget, President Obama proposed putting off the
cuts for another two years at a cost of $62 billion. But Medicare
officials have since upped that figure by another billion. The
president’s budget estimates the cost of eliminating the current
payment formula over 10 years at $369.8 billion, but that figure
could go higher, too.

Physicians have been asking for years for a permanent fix to the
sustainable growth rate (SGR) formula under which their payments
are calculated. Every year since 2002, that formula has resulted in
a negative update, but Congress has passed a series of temporary
“doc fixes” to stop the rate reductions. In mid-December, the
Medicare and Medicaid Extenders Act of 2010 prevented any cuts for
2011.

In a March 10 letter to the House and Senate, the American
Medical Association, along with 130 other physician and related
groups, urged Congress to “begin working in a bipartisan, bicameral
manner to enact legislation this year that will eliminate
Medicare’s sustainable growth rate (SGR) formula and lay the
groundwork for adoption of broader physician payment and delivery
reforms.”

“The new estimate from CMS should serve as a wake up call to
Congress that physicians who serve Medicare and TRICARE patients
are facing a debilitating cut of nearly 30 percent on January 1,”
AMA President Cecil B. Wilson said in a statement. “This cut is the highest ever
scheduled under the broken Medicare physician payment system, and
it threatens access to care for our nation’s seniors, military
families, and the baby boomers now entering Medicare.”

In a letter to the Medicare Payment Advisory Commission
about the physician cuts, CMS’ Jonathan Blum, deputy director
and director of the Center for Medicare, said that a long-term
solution is needed. “We will continue to work with Congress to fix
this untenable situation so doctors no longer have to worry about
the stability and adequacy of their payments from Medicare,” he
wrote. MedPAC advises Congress on issues affecting Medicare.