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.