AMA Past President Warns on Scheduled Medicare Physician Payment Cuts
The immediate past president of the American Medical Association warned on Monday that many doctors will stop treating Medicare beneficiaries if a scheduled 4.3% reduction in Medicare physician payments takes place on Jan. 1, 2006, the Memphis Commercial Appeal reports. Speaking at a meeting with physicians at the University of Tennessee Health Science Center, John Nelson noted that a recent AMA survey found 38% of doctors plan to stop treating new Medicare beneficiaries if the scheduled payment cut takes place.
He called on physicians and beneficiaries to urge Congress to support legislation that would reform Medicare's physician reimbursement system. "We need to let people know that our seniors' care is at risk," he said. AMA supports legislation that would increase Medicare physician payments at least 1.5% next year and link future payments partly to the inflation index. Mary Knish, a spokesperson for AARP Tennessee, said, "We want physicians to be fairly compensated, but whatever fix must be balanced with the impact it would have on the premiums paid by beneficiaries" (Powers, Memphis Commercial Appeal, 8/16).
In related news, the Medicare Rights Center on Monday released a report warning that "millions" of Medicare beneficiaries could experience disruptions in their medication regimens when the new Medicare prescription drug benefit begins. People who are mentally ill and dually eligible for Medicare and Medicaid will be particularly affected by the switch, the report says. According to the MRC, the new benefit will improve access to prescription drugs for many Medicare beneficiaries, but dual eligibles might find that drugs currently covered by Medicaid will not be covered by private Medicare drug plans.
The report also raises concern that the enrollment process for the new benefit could be difficult for mentally ill beneficiaries to navigate. MRC said that if Congress does not address such issues, Medicare should require drug plans to offer beneficiaries a transitional supply of the medications covered under Medicaid, establish a transition hot line and simplify the enrollment process. "The disruption of drug coverage will be devastating to the poorest, frailest and most disabled Americans," Robert Hayes, president of MRC, said, adding, "Congress and the White House are on notice that people with mental disabilities are being put in harm's way without an assurance that current medications will be maintained."
A CMS spokesperson said the report's concerns already have been addressed by a regulation that requires dual eligibles to be automatically enrolled in the benefit and placed in a drug plan. Dual eligibles "will not lose any coverage if they do not choose a plan," the spokesperson said, adding, "The formularies we've seen so far cover virtually every mental health drug, so there's not likely to be any difficulty transitioning from Medicaid to Medicare" (Heil, CongressDaily, 8/15). The report is available online. Note: You will need Adobe Acrobat Reader to view the report.
The Modesto Bee on Monday examined CMS' plans to launch a three-year pilot program to test whether physician visits to Medicare beneficiaries' homes can improve care and reduce spending. Under the program -- to be launched in California, Florida and Texas this fall -- Medicare will contract with private companies to administer home-visit programs. Medicare will pay the agencies a monthly fee for each beneficiary in the program, and the agencies will provide doctors to perform the home visits.
CMS Administrator Mark McClellan said the test will show if beneficiaries get the "best possible prevention-oriented care," adding that organizations that provide "better quality care at lower costs" will be rewarded. Medicare will decide which beneficiaries participate in the program. Raouf Khalil, chief operating officer at Care Level Management, said participating beneficiaries likely will be those with high health costs related to emergency department visits and hospitalizations. Khalil predicted the pilot program would show a reduction in ED admissions by 60% and hospital costs by 30% (O'Rourke, Modesto Bee, 8/15).
Continuing the administration's promotion of the new Medicare drug benefit, HHS Secretary Mike Leavitt on Friday attended a rally with more than 100 beneficiaries and health professionals in Las Vegas. Rep. Jon Porter (R-Nev.), Gov. Kenny Guinn (R) and Nev. Attorney General Brian Sandoval (R) also attended (Swafford, Las Vegas Sun, 8/15).
Leavitt traveled to Washington state and Oregon on Monday to meet with government, tribal, business and not-for-profit organization leaders who are working on the prescription drug program. Stops on the tour included Seattle, Olympia and Portland (Ammons, AP/Spokane Spokesman-Review, 8/16).
Additional information on the Medicare drug benefit is available online.