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Life Health > Health Insurance > Medicare Planning

Concern Rises Over Medicare Cuts to Doctors

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Ninety-four percent of Americans are concerned about a looming Medicare cut to doctors, according to a new American Medical Association (AMA) poll released recently at the organization’s semi-annual meeting of physician leaders from across the nation. Without congressional action, physicians caring for seniors face a 25 percent cut.

About one in five physicians say they have been forced to limit the number of Medicare patients in their practice because of the ongoing threat of cuts and the fact that Medicare payment rates were already too low. “Physicians want to care for seniors, but it is nearly impossible for many physicians to keep their practices open to all Medicare patients when they face a 25 percent payment cut,” said AMA president Cecil B. Wilson.

AARP is also concerned. “Congress has a responsibility to keep doctors in the Medicare program,” said AARP board member Mara Mayor. “It’s time for politicians to come together to stop these cuts so seniors can have the peace of mind they’ve earned.”

“There is a growing concern that Medicare is becoming an unreliable payer,” Dr. Wilson said. “Congress must allay that fear by stopping the cut for at least 13 months, which will provide time to begin working on a permanent solution in the New Year.”

The cuts are scheduled to take effect Dec. 1, and would reduce payments by 23 percent for the rest of the year and an additional 1.9 percent beginning in January. A temporary fix would solve the problem for 13 months, with a $15.4 billion price tag.

Medicare payments to physicians are calculated using “sustainable growth rates” – a formula approved by Congress in 1997. The amount is set each year in March, based on the gross domestic product. Since 2003, Congress has overridden the formula to prevent cuts to physician reimbursements.

This year, the formula called for a 21.2 percent cut to physician payments. Congress delayed the cut three times in the spring.

But earlier this year, during three weeks in June when the extension had expired and a new one hadn’t yet been approved, 57 percent of medical practices limited care to Medicare patients. Physicians were forced to delay payments to suppliers and staff and take out loans to cover overhead expenses.

In June, lawmakers voted to extend the same rates for six months and added a 2 percent payment increase for June-November.

The AMA’s is campaigning for a 13-month extension, rather than a shorter extension until Congress reconvenes next year, taking advantage of the completely Democratic Congress. The Democrats will put the cuts on the legislative agenda this month.

When asked how he thought the payments should be funded, Wilson said he was confident Congress could find a way.

“This is their responsibility,” he said.


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