Payment Changes Could Reduce Physician Medicare Participation

Forty-five percent of physicians in the American Medical Association plan to decrease or stop the acceptance of new Medicare beneficiaries and TRICARE members if Congress does not act to stop a 5% decrease in Medicare physician payments that is scheduled to take effect in 2007, AMA President Jeremy Lazarus said on Tuesday, the AP/South Florida Sun-Sentinel reports.

Speaking at a hospital in Tampa, Fla., Lazarus said, "Over the next nine years, Medicare will cut physician payments 37% unless Congress acts before Jan. 1, 2007," adding, "At the same time, the cost of caring for those patients will increase 22% -- and that math just doesn't add up."

The Bush administration has said the payment reductions are necessary to slow spending growth in Medicare.

Meanwhile, 80 members of Congress sent a letter on Monday urging Senate leaders to take up debate on the payment schedule issue before Congress adjourns in October.

The letter, signed by Sen. Mel Martinez (R-Fla.), Sen. Hillary Rodham Clinton (D-N.Y.) and others, states, "These projected cuts will destabilize the Medicare program and put at risk all patients' access to health care" (Davis, AP/South Florida Sun-Sentinel, 7/19).

In related news, several lawmakers and witnesses testifying at a hearing of the House Energy and Commerce Subcommittee on Health said scheduled reductions in Medicare payments for medical imaging should be delayed until 2009 to allow the Government Accountability Office to study the cuts' potential impact, CQ HealthBeat reports. The cuts, which would reduce payments by $2.8 billion over five years, are included in a fiscal year 2006 spending cut package.

At the hearing, Rep. Charlie Norwood (R-Ga.) asked Glenn Hackbarth, chair of the Medicare Payment Advisory Committee, for "proof" that the cuts were needed in part to discourage physicians from supplementing their incomes by ordering many medical imaging tests.

Hackbarth said, "I can give you examples of it happening," adding that companies have promoted medical imaging to physicians at conferences as a method of increasing income.

Rep. Lois Capps (D-Calif.) expressed concern that the cuts would limit cancer patients' access to radiation therapy.

Herb Kuhn, director of the Center for Medicare Management at CMS, said the agency hopes to address that issue during the comment period for an upcoming rule proposal on how to implement the scheduled payment reductions (Reichard, CQ HealthBeat, 7/18).