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Medicare cuts hit doctors as Congress feuds

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With the unthinkable happening, physician offices will begin receiving payments from Medicare that are 21.3-percent below what they’ve been getting so far this year. Doctors still expect Congress to reverse the payment cuts, but physicians and the Medicare program will have to reprocess claims, costing both extra money.

The cuts went into effect on Friday, the same day the U.S. Senate passed a bill that instead would give doctors a 2.2-percent hike in payments, at least through November.

But the U.S. House of Representatives has not passed the bill, and Speaker Nancy Pelosi (D-Calif.) is holding out for a broader bill that also would extend assistance programs for the unemployed, something the Senate bill does not include.

Pelosi said she saw “no reason” for the House to pass the Senate’s bill, according to CQ Today, a daily newsletter covering Congress.

Don Stumpp, president of Indiana Medical Group Management Association, said the cost to reprocess Medicare claims likely would offset all of the 2.2-percent increase in the bill. Reprocessing will also cost the Medicare program 30 cents per claim, according to an estimate by the Congressional Budget Office.

Congress has delayed the Medicare cuts several times this year. The cuts are prescribed by a formula adopted by Congress in 1997 called the "sustainable growth rate," or SGR.

“The continuous delays and fixes have been nuisances, but now that [the Medicare program] is actually processing reduced claims, Congress needs to realize they are affecting millions of people covered by Medicare, the Medicare Advantage plans and TriCare, the health care program for the military,” said Stumpp, who is also director of payer contracting at American Health Network physician practice in Indianapolis. “It is unbelievable that politics are now being played as the ‘Doc Fix’ is being held hostage for other legislation.”

Medicare, the taxpayer-funded insurance program for seniors, contributes the largest single chunk of revenue for most physician practices. The Medicare program's  administrators had been holding claims filed since June 1 in expectation that Congress would delay the schedule cut, building up a backlog of 50 million claims. On Friday, the Medicare agency said it would begin paying those claims at the new, reduced rate.

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  • the forest
    i feel for my fellow honest, care-driven physicians. given we are brainwashed with an ass-kissing mentality throughout our training processes, is it any surprise why things haven't been going our way lately. lets leave the shrubs (medicare cut backs) alone and look at the forest (healthcare in US) for a moment. health care reform signed in march 2010 continues our slavery. it was our chance to escape a fascist corporate system's death grip across our throats, a fundamentally flawed system that will never-- did u hear, never, work. and by definition, it can only get worse. this concept has been beaten to death by eminent economists, but common sense alone and basic understanding of the corrupt system will enlighten thee. how is it i am able to graduate from med school without bombardment of these issues is absurd. we should be enraged and ready to challenge the system as graduates. but we leave feeling we are the privileged of society, the beacon of integrity and hope. of course, this is by design. i never had a step I, II, or III question testing my understanding of public option vs. single payer system vs. third party insurance plans. have any of you? why not? these are the questions you should ask when you lay down at night and wonder why we face so many practice issues regarding sustainability. we're thrown into residency struggling for sleep ops, so forget time to petition for our voices to be heard. we only realize how truly powerless we are when we're smacked across the face our first day in the real world as an unsupervised physician. ouch! we were taught to put our trust in the likes of ama and such. i would say lets fight back, but unless we have a national concerted effort via physicians joining forces across the nation, there is little hope. furthermore, i'm afraid the brainwashing is permanent for many of our esteemed colleagues.
    jo
  • Medicare Meltdown
    I have given 24/7/365.25 for 25 years. I am still willing to give but my office manager says IT WOULD BE MORE MERCIFUL AND SWIFT TO MEET EACH MEDICARE PATIENT AT THE DOOR, GIVE THEM 5 DOLLARS TO GO AWAY.....IS ANY ONE STILL LOOKING FOR WEAPONS OR PEOPLE OF MASS DESTRUCTION???...DID SOME ONE SAY RETENTION BONUS???
  • Medicare Cuts
    I will not see ANY medicare patients tomorrow. Urgent problems will go to the ER,
    others will be rescheduled for a LATER date
  • Medicare Cuts will change the medical system
    I am a working physician who spends far more time with each of my Medicare patient. Each has multiple medical issues and most have chronic kidney disease and hypertension. This cut and the lack of insight by lawmakers and politicians will change the "face" and fate of medicine. I consider this a turning point.

    I have reduced office times in half for all new patients and reduced the alotted time for patients by 25%. This will result in less doctoring per visit.

    I may find that staff and physicians on the payroll are too expensive soon. Most likely this result in layoffs for my staff. The work will be shifted to primary care providers.

    Lastly, many physicians, including this one, have been considering leaving medicine or at the least opting out of Medicare due to this untenable fee structure. Since the consult codes have been eliminated and now the fee schedule slashed, I dont see how many of us will survive.

    So, EVERYONE out there, this is what the POLITICIANS in Washington have done to health care REFORM. I blame both sides of the aisle.

    So long to affordable, high-quality health care.
  • Medicare cuts
    SPEAKER PELOSI, AS WE CLOSE OUR DOORS AND MEDICARE PATIENTS AND PATIENTS IN GENERAL CAN NOT ACCESS MEDICAL CARE MAYBE THEN YOU'LL "SEE A REASON" TO DO SOMETHING. NO OTHER BUSINESS WOULD PUT UP WITH LETTING THEIR INCOME BE HELD HOSTAGE... TO SAY NOTHING OF A 21% DECEASE IN PAYMENT, WHILE ALL OUR EXPENSES KEEP GOING UP AND UP... WE SEE NO REASON TO RE ELECT ANY OF YOU !!!!
  • Go ahead...make the cut!
    Go ahead. Let the cuts stand. The American public needs to know that primary care physicians are ALREADY at the breaking point. Let's let it fly so that the impact of such adjustments can be considered as "health care reform" proceeds.

    Remember, people CHOOSE to work as physicians. If they can't earn enough to support office staff and mandates (electronic medical record anyone?) they will STOP working.

    So, let's let the politics play out and call the "Washington Bluff".

    Just as people get the politicians they deserve, we ultimately get the healthcare (or any other service!) that we pay for.

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