Delays Pending Cuts, Extensions Are Approved
The threatened 21 percent cut in Medicare
physician payment has been postponed until June 1, leaving physicians
questioning their ability to serve the needy.
Staged-off by Congress, the cuts were pushed back
from the original deadline of March 1 to April 1 and now June 1,
unfavorable consequences are expected by physicians while they continue
to protest for a suitable solution.
"Even before these cuts went into effect, there
was widespread frustration and concern among doctors nationwide.
Between increased time dealing with paperwork and fighting government
red tape over payment, it was becoming harder and harder for doctors to
keep their practices open. With these massive cuts, the increase in
costs will make it even harder for doctors to keep their practices
open. With these massive cuts, the increase in costs will make it even
harder for doctors to do the thing they care about the most: spending
time helping their patients," said Dr. Lou Goodman, president of The
According to research by the Foundation, 82
percent of primary care doctors believe their practices will be
"unsustainable" if the proposed cuts are applied.
"Congress must now turn toward solving this
problem once and for all through repeal of the broken payment formula
that will hurt seniors, military families and the physicians who care
for them. It is impossible for physicians to continue to care for all
seniors when Medicare payments fall so far below the cost of providing
care," said Dr. J. James Rohack, president of the American Medical
"In an informal poll, 68 percent of physicians
tell the AMA they will be forced to limit the number of Medicare
patients they can care for. Already, about one in four Medicare
patients seeking a new primary care physician are experiencing
difficulty finding one," Rohack continued.
The habitual complaint about the yearly Medicare
physician payment update is the sustainable growth rate (SGR).
One respondent to AMA’s poll, a
urologist in Cadillac, Mich., said, "I am not sure which is more
disruptive; the constant uncertainty each year regarding the SGR, the
actual 21 percent cut, or the payment freezes that are now seemingly
routine. One thing is for sure, my office will attempt to minimize our
exposure to the now-politicized Medicare program. Starting now, we will
limit the number of new Medicare patients to 3 per week per provider
(down from about 7) and limit surgeries to emergent cases on our
existing Medicare patients."
"... We should not be running Medicare on a
month-to-month basis," said Senator Chuck Grassley of Iowa, and ranking
member of the Committee on Finance.
"These cuts to physician payment cannot be allowed
to occur. And as damaging as these would be to beneficiary access to
care anywhere, these cuts are even more disastrous for access to care
in ruralstates, like Iowa, where Medicare reimbursement is already at
least 30 percent lower than in other areas," he continued as he
introduced amendments to the Tax Extenders Act of 2009.
One of the amendments he proposed was to delay the
pay reductions by 10 months until Dec. 31.
"I fought for my amendment to make sure the cost
of important Medicare provisions wasn’t added to the federal
deficit, but the majority leader worked to block it and, unfortunately
for tax payers, he succeeded," Grassley concluded.
While the pay cut extension was denied before
Congress, several other extensions were approved, they are:
- extension of therapy caps to Dec. 31;
- extension of pharmacy accreditation deadline
under durable medical equipment to Jan. 1, 2011;
- extension of the mental health add-on until
- extension of ambulance add-ons until Jan. 1,
- extension of geographic floor for work to
before Jan. 1, 2011;
- extension of outpatient hold harmless provision
until Jan. 1, 2011;
- extension of Medicare Rural Hospital
Flexibility program to include 2010, and supply grants until funds are
- extension of section 508 hospital
reclassification from Sep. 30, 2009 to Sep. 30.
Addresses: American Medical Association, 515 N.
State Street, Chicago, IL 60654; (800) 621-8335, www.ama-assn.org.
The Physicians Foundation, 77 Summer Street, 8th Floor, Boston, MA
02110; (617) 399-0417, www.physiciansfoundations.org.
Senator Chuck Grassley, 135 Hart Senate Office Building, Washington DC
20510; (202) 224-3744, http://grassley.senate.gov.