Tuesday, December 13, 2005

Physician groups this week stepped up pressure on Congress to reverse Medicare payment cuts, with doctors warning that they will limit services to such patients if the cuts are enacted.

Medicare, the federal health insurance program for senior citizens and the disabled, is set to reduce doctor payments by 4.3 percent starting Jan. 1.

Dr. William A. Hazel, a Herndon orthopedic surgeon, said the payment cut coupled with the rising costs of running a practice will push doctors to limit their services to Medicare patients.

“There will need to be some cutback in terms of access to new Medicare patients. Some doctors are actually talking about dropping their participation with Medicare,” said Dr. Hazel. He also is considering limiting the number of Medi-care patients he treats.

About 38 percent of 5,486 doctors surveyed in February said they will reduce the number of new Medicare patients they accept next year because of the cut, according to the American Medical Association, a Chicago trade group.

Ashland, Ky.-based family physician Dr. Larry Fields said he will keep his Medicare patients, which make up about 35 percent of his practice, but may reduce his office hours and number of new Medicare patients.

“We will continue to provide the same services, just on a smaller margin,” said Dr. Fields, president of the American Academy of Family Physicians, a Leawood, Kan., medical society.

Washington senior citizen group AARP called the doctors’ plan an “idle threat.”

“The physician community feels that this promise of limited access resonates with Congress,” said spokeswoman Andrea Price, adding that Medicare beneficiaries end up paying for increases in Medicare’s pay to physicians.

About 25 cents of every $1 increase in Medicare physician pay is passed on to a beneficiary’s rate, Miss Price said.

The Medicare Payment Advisory Commission, which advises Congress on Medicare, said last month that doctors increased their services to Medicare patients steadily over the past few years, even when payments were lower.

The Senate in its version of legislation replaced the cut with a 1 percent increase for Medicare payments to doctors for next year. But the House did not put a similar measure in its bill.

Congress this week is negotiating how to handle the Medicare payment issue, but did not make a decision by yesterday afternoon, said a spokeswoman for the House Ways and Means Committee .

Even if the pay cut is reversed, Congress may adopt a pay-for-performance plan, which in 2007 would dock 2 percent of a doctor’s Medicare pay if the physician did not report quality data to the federal government.

The battle over doctor payments will get more intense next year when Medicare rolls out its drug benefit, said Michael Cannon, spokesman for the Cato Institute, a Washington libertarian think tank.

“There is no way current revenues can fund all the promised benefits under Medicare. So the government is looking at places to cut and they will look at physicians and hospitals,” he said.

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