Close Close

Life Health > Health Insurance > Medicare Planning

Medicare roundup: Bills, doctors and elections

Your article was successfully shared with the contacts you provided.

The Senate passed the “doc fix” bill in late June (until Nov. 30). The House approved the bill, even though Nancy Pelosi told the press that she didn’t support the legislation, because “it has no job-creation measures.” Well, Nancy, how about job “preservation” measures and “doctor accessibility” measures? How about making sure that the nation’s general practitioners are willing to stay with Medicare so that our clients have access to basic medical care? How about taking Medicare doctors off the merry-go-round so that they will want to continue their practice for older people who rely on Medicare?

What was the actual name of the bill? Get this: “The American Jobs and Closing Tax Loopholes Act of 2010.” That’s a stretch. There was a 10-day period during all this, when the Centers for Medicare and Medicaid Services (CMS) actually put a hold on paying doctors until the matter was resolved, and then a few-day period when they paid on the 21 percent cut, and then a short time when they went back and reimbursed for the cuts. It’s government efficiency at its best.

The problem of the SGR (Sustainable Growth Rate) formula for doctor payments has become a national embarrassment and Congress refuses to provide a permanent solution– just patching things up every few months. All summer long I have continued to get reports of good doctors who are simply tired of the uncertainty, and indicate they cannot afford to continue losing money on Medicare patients.

USA Today reported that “up to 13 percent of the members of the American Academy of Family Physicians don’t accept Medicare (in 2010), compared with 6 percent in 2004. The American Medical Association, meanwhile, reported that 17 percent of its members restrict the number of Medicare patients they will see. That number climbs to 31 percent among primary care physicians.” At the same time, CMS continues to insist 97 percent of doctors accept Medicare, but don’t know how many have refused to take new Medicare patients.

The USA Today article says that in Illinois, 18 percent of doctors restrict the number of Medicare patients in their practice, and in New York, 1,100 doctors have left Medicare. One report out of Texas indicates that 37 percent of doctors will opt out of Medicare. In short, if it’s happening in other states, it’s happening in yours. Be alert.

In the meantime, Kathleen Sebilius, head of HHC, says $250 million is being made available to devote to training for primary care providers through PPACA– a pittance in comparison to the need to replace family doctors.

Even liberal organizations are admitting that Medicare patients are starting to lose their doctors, however, most see it as not continuing because Congress always comes to the rescue, and doctors are not going to give up the Medicare cash cow. Really? The doctor who has been tempted to leave Medicare because of payment-reducing threats several times in the past year, and over the past five years, probably has a different viewpoint.

One thing we can count on: after the heat of the Nov. 2 elections, this issue will be front and center again. We will be flooded with articles and information regarding the doc fix, and the Nov. 30 band-aid deadline will come with more angst for everyone involved.

Become familiar with the use of the “Insider Pages Doctor Finder.” You may need it as this problem continues to fester. You may be asked to help your customers find a doctor for them, and you can use this source:


© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.