AMA Says Scheduled Medicare Provider Reimbursement Cuts Would Harm Access to Care
The American Medical Association yesterday urged Congress to change the Medicare provider reimbursement formula to prevent a scheduled cut in physician payments, saying that unless the reduction is reversed, some doctors might stop treating beneficiaries, the Detroit News reports. In January, payments to physicians were cut 5.4% and payments will be gradually reduced by another 12% between Nov. 1, 2002, and 2005. The latest reductions could reduce provider payments by $11 billion over the three years, according to an AMA analysis released Monday. The provider payment reductions are in addition to a series of cuts implemented this month for home health care providers, physical therapists and others who treat Medicare beneficiaries, the News reports (Kozlowski, Detroit News, 10/16). The AMA report also found 42% of physicians will not participate in Medicare if the November cuts take effect, the Florida Times-Union reports. More than 20% of doctors already have limited or plan to limit the number of Medicare beneficiaries they treat because of the payment reductions (Skidmore, Florida Times-Union, 10/16). AMA President-elect Donald Palmisano said, "Time is of the essence. ... This is a crisis of great proportions and it will directly affect the health of America's seniors" (Rovner, CongressDaily, 10/15). He added that while doctors "want to serve America's seniors ... they simply cannot afford to accept an unlimited number of Medicare patients into their practice" (Bleed, Arkansas Democrat-Gazette, 10/16).
CongressDaily reports that the AMA supports language addressing the payment reductions in the House-passed Medicare reform package and in the Medicare provider "giveback" bill sponsored by Sens. Max Baucus (D-Mont.) and Charles Grassley (R-Iowa) (CongressDaily, 10/15). The House in June passed a $30 billion Medicare reform bill that includes provisions to increase reimbursements for providers, as well as a drug benefit for seniors, but the Senate has not yet reached agreement on its package. The 10-year, $43 billion Baucus-Grassley bill includes smaller than planned reimbursement reductions for hospitals and increases for rural physicians, hospitals and home health care agencies. Medicare+Choice plans would receive a 4% reimbursement increase in 2003 and a 3% increase in 2004 under the legislation. The bill also would reverse the expiration of $1.7 billion in temporary Medicare reimbursements for nursing homes that ended Oct. 1 (California Healthline, 10/10). Given that prospects for the Senate bill are dim and that Congress is nearing adjournment, the AMA has indicated support for adding the giveback language to any other bill, even the continuing budget resolution, CongressDaily reports (CongressDaily, 10/15).
Meanwhile, some senators are trying to pass the Baucus-Grassley bill this week, CongressDaily/AM reports (CongressDaily/AM, 10/16). Earlier this month, Baucus and Grassley invoked a Senate rule to bypass the Senate Finance Committee and move the bill directly to the floor for a vote, a motion that requires unanimous consent. However, Sen. Don Nickles (R-Okla.) objected to the motion, saying that he hoped to adjust the rural hospital wage index and reform the outpatient reimbursement system. Nickles also said that the Finance Committee had not considered the bill and that some committee members, such as Sen. Olympia Snowe (R-Maine), hoped to add a prescription drug benefit (California Healthline, 10/7). Although lawmakers continue to work on the bill, it is not known whether the Senate can pass the package and negotiate a compromise with the House before Congress adjourns, the AP/Las Vegas Sun reports (Carter, AP/Las Vegas Sun, 10/15). House Republicans are considering holding a floor vote on a "slightly revised version" of the reform package they passed in June, an indication that they might be "backing down a bit" from their earlier refusals to remove the giveback provisions from the overall Medicare package, CongressDaily/AM reports (CongressDaily/AM, 10/16).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.