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Senior Citizen Opinions & Analysis
What Happens Every December? The Battle to Stop
Medicare from Cutting Physician Pay
Usually the proposed cuts are just pushed ahead but
this year looks different - although Washington stockings are getting
filled
By Tucker Sutherland, editor
 Dec. 7, 2007 – Just like Thanksgiving comes every
November, the battle over Medicare cutting the pay of doctors comes
every December. Once again, Medicare has announced a big pay cut, the
physicians and their lobby are pouring money into the political
stockings
held by the Washington politicians, and, alas, once again the pay cut
will be avoided. This year, however, the stakes appear a little larger,
battle lines are more skewed and it is harder to predict how the
politicians will make it happen.
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First, the pay cut already approved by the
Administration is 10 percent, considerably more than in past years.
Secondly, the power is unusually divided – the Democrats control the
House but in the Senate they don’t have enough votes to override a veto.
The Democrats have been trying to figure out for months how to get the
money to pay the docs from cuts in the subsidy Medicare pays to Medicare
Advantage plans.
The Medicare Advantage program is a sacred cow for
the Bush Administration, which promises to veto any bill that transfers
subsidy money from the MA plans to the physicians.
The American Medical Association, which has been
lobbying hard with the same cry they use every year – if you cut the pay
doctors will not take Medicare patients. This year, however, a new
wrinkle to their demands has arisen.
This year the doctors are trying to put an end to
the annual battle, which has usually resulted in the politicians
delaying the pay cut to some future year. It has looked like that is
where the argument in the Senate finance committee was headed. The only
fight was the Democrats want to delay it longer than the Republicans.
It appears the medical lobby is telling people in
Washington that they will not back a bill that just moves the problem
ahead a year or two. That is what happened last year, when Medicare
proposed a 5% pay cut, which was pushed forward by the Republican
controlled Congress to be 10% this year.
That bill was passed at 4 a.m. on Saturday, Dec. 9,
just before Congress closed down for the holidays.
The AMA's then chairman, Dr. Cecil Wilson, said,"
Congressional action to avert next year’s five percent Medicare
physician payment cut will help avert a potential sharp decline in
access for America’s seniors."
He added, “"If the 2007 Medicare cut had occurred
as planned, nearly half of physicians told the AMA the cut would force
them to limit the number of new Medicare patients into their practice.”
“The AMA renews its commitment to work with
Congress the Administration and senior groups on a more permanent
solution to the flawed Medicare physician payment formula,” Wilson
said.”
Well, here we are again with senior citizens who
depend on Medicare caught in the middle between the politicians who want
all the contributions than can squeeze out of the doctors and the
doctors who are willing to keep falling for this game year-after-year.
There will not be a permanent fix this year,
although everyone will pledge to work on it, as they always do, but the
pay cut will go away for another year. The only thing that has not been
decided is how to pay for the cut, but that will be worked out in some
creative way.
Let’s just hope it doesn’t somehow punish senior
citizens. Below is a report on how it stands today.
Kaiser Health Network’s Daily Report
AMA Opposes Cost Shift for Reversal of Medicare
Physician Fee Cut
A Medicare bill under consideration in the
Senate Finance Committee that would reverse a reduction in physician
reimbursements scheduled to take effect on Jan. 1 should not shift the
cost of the reversal to future years, according to a draft letter from
the
American Medical Association addressed to the committee,
CQ HealthBeat reports.
AMA this week circulated the letter to other
physician lobby groups for signatures but did not send the letter
because Finance Committee Chair Max Baucus (D-Mont.) on Wednesday
canceled the mark up of the Medicare bill in favor of direct
negotiations with the
House Ways and Means Committee (Armstrong/Carey, CQ HealthBeat,
12/6).
In recent weeks, Baucus has debated with committee Republicans over
whether to reverse the reduction in Medicare physician reimbursements
for one year or two years, as well as over reductions in Medicare
Advantage payments to help fund the reversal. Baucus canceled a mark up
of the Medicare bill one day after the Bush administration threatened to
veto any legislation that includes reductions in MA reimbursements (Kaiser
Daily Health Policy Report, 12/6).
The draft letter states, "We urge members of the Senate Finance
Committee to develop" a sustainable growth rate provision that "properly
funds a solution to this problem and does not rely on 'balloon'
financing," adding, "If the Finance Committee were to propose such an
approach, the undersigned organizations would be forced to oppose the
proposal."
According to CQ HealthBeat, to address the issue in the past, "lawmakers
have sometimes resorted to a 'budget gimmick' that uses much larger
future cuts to provide an offset for more immediate spending."
The
practice "has caused a hole so deep lawmakers are having trouble finding
the dollars to fill it," CQ HealthBeat reports (CQ HealthBeat, 12/6).
Links from our Medicare Section
Medicare Finalizes Expected 10 Percent 2008 Pay Cut
for Physicians
Congress expected to intervene with slight pay
increase
Nov. 2, 2007 – Physicians will receive a 10 percent
pay cut for treating Medicare patients in 2008, according to an
announcement that had been expected from the Centers for Medicare &
Medicaid Services (CMS) on Thursday. CMA said it issued a final
physician payment rule designed to improve accuracy of Medicare payments
and give physicians and health care professionals additional financial
incentives to provide higher quality and value in the delivery of care.
Read more...
AMA Survey Says Physicians Won't Take Medicare
Patients if Pay Gets Cut
Campaign to stop physician payment cuts says senior
citizens lose
June 4, 2007
Congress, AMA, Advocates All Targeting Medicare
Advantage Private Fee-for-Service Plans
AMA says most members report their patients were
denied coverage
May 24, 2007
Democrats Consider Eliminating Extra Pay to Medicare
Advantage Plans to Raise Physician Pay
Medicare Payment
Advisory Commission's report under fire on docs’ pay
March 7, 2007
Senior Citizens in the Middle Again of Fight Between
Medicare Advantage Providers and Congress
Medicare Advantage fight a lot like Medicare+Choice debacle
Feb. 28, 2007
Final Bill of this Congress Saved Physicians from
Big Medicare Pay Cut
AMA says it will help
avert a potential sharp decline in access for America’s senior citizens
December 10, 2006 – Sometime shortly before 4 a.m.
Saturday the Congress finally managed to pass legislation that will
stop Medicare from cutting what it pays physicians. On January 1, a 5.1
percent pay cut was to take affect. The measure passed by large margins
in both the senate and house but was packaged with a number of other
items the congressional leadership wanted to get passed before this
Congress ended.
Read
more...
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