Congress urged to end Medicare physician payment formula

Physician, senior and military groups gathered Thursday in a five-city event to urge the permanent repeal of the broken Medicare physician payment formula that, they say, threatens access to care for millions who depend on Medicare and TRICARE.

“Every time Congress kicks this can down the road and fails to permanently repeal the payment formula, the price tag grows,” said Nancy Nielsen, M.D., AMA immediate past president and internist from Buffalo, N.Y.

Had congress fixed this problem permanently in 2005, the price tag would have been $49 billion, she said. Now the price tag has skyrocketed to $210 billion and doctors are facing a 21 percent cut.

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President Barack Obama signed a measure in December 2009, that postponed a 21.2 percent Medicare physician pay cut until March 1, 2010.

The measure was part of the Department of Defense Appropriations Act, passed in early December, by Congress. The measure came in the 11th hour, as physicians were expected to take the pay cut on Jan. 1, 2010.

The Medicare Physician Payment Reform Act of 2009 (H.R. 3961), was passed by the House this fall, which would repeal and replace the current Medicare physician payment formula, or the sustainable growth rate.

The Senate is in the hot seat now.

“It’s time to give stability to Medicare and TRICARE and fix the broken payment system once and for all,” said Cecil Wilson, M.D., AMA president-elect and internist from Winter Park, Fla.

“Military benefits are (also) tied to Medicare,” said Captain Kathy Beasley, U.S. Navy Retired, MOAA deputy director of Government Relations for Health Affairs. “Those who don’t live near military facilities are particularly at risk. The cuts are causing large numbers of doctors to stop seeing elderly and military patients.”

“With a 21 percent cut, some physicians may decide to no longer accept Medicare patients,” said Rodger Wetzel, AARP Executive Committee member. “There are few physicians in rural areas to begin with, finding a doctor will become increasing difficult for seniors in Medicare.”

Ardis Hoven, M.D., AMA board chair-elect and Infectious Disease Specialist from Lexington, KY said that Primary physicians at Mayo Clinic in Glendale, Arizona aren’t accepting Medicare payments anymore.

“The cuts will cause a below average ratio of physicians to patients,” she said.