November 18, 2005

 

CALL TO ACTION: House and Senate To Meet on Budget Bill –
Medicare Physician Payment Fix on Agenda

All ASA Members Are Urged to Contact Their U.S. Senators and Representative to Urge Enactment of a Fix for Medicare Physician Fees

Members of the U.S. House of Representative and U.S. Senate will soon meet in a Conference Committee to work out differences in their respective versions of the 2006 budget. A key issue for consideration by these “conferees” is the status of physician fees for 2006 and beyond.

Early Friday, November 18, by a margin of 217 to 215, the U.S. House passed its version of the 2006 budget package. This House package contains NO provisions to fix the Medicare physician payment reductions scheduled for the future including a 4.4% reduction expected for 2006.

The Senate version of the budget, passed November 3 rd by a vote of 52-47, includes a 1% update for 2006 fees yet ties the update to a “pay-for-performance” system with added payment cuts.

Urgent action is needed to avert Medicare fee cuts.  Our message to Congress is simple: 

-- Please work together with the Administration for positive physician updates in 2006 and beyond that are not tied to a “pay-for-performance” system with added payment cuts.

-- Any mutually agreeable final budget MUST include the Medicare physician fee fix provisions.

Please go to the ASA Legislative Action Center to e-mail or fax your Senators or Representatives now!  ASA members must join all of organized medicine in letting Congress know that Medicare CF cutbacks are unacceptable and cannot be allowed to occur.  Congress can and must act now or cuts will occur soon across all of Medicare Part B.  The legislative clock is ticking, and every day there is less time to avoid this rollback. Only with Congressional action will a positive Medicare update occur.

Under current law, if Medicare Part B spending goes up more than the average rate of economic growth in the United States in any one year, then physicians and other Part B providers have to absorb these costs in reimbursement cuts the next year as Medicare calculates and applies the Sustainable Growth Rate (SGR).

Every year there are more and more seniors, living longer, with enhanced opportunities for innovative medical interventions and life-saving surgery through Medicare.  The SGR presumes that physicians can work single-handedly to restrain this growth in required government spending.  Otherwise, physicians will see reimbursement cuts because seniors require more medical care.  As the typical anesthesiologist knows all-too-well, there is little he or she can do to reduce either the volume or intensity of anesthesia care without risk of severely adverse outcomes.   SGR reform is the only way to right this wrong!

MedPAC, the very entity that Congress created to advise it on physician reimbursement matters, has recommended a positive Medicare physician update for 2006 and replacement of the SGR formula with an index that reflects the actual rise in medical costs, such as the MEI.  This is what Congress needs to do through the budget reconciliation process occurring within the month.   To do less will threaten patient access and only drivemany physicians and other Part B providers away from their willingness to treat our nation’s seniors.

 Please act now!  Click here to go to the ASA Legislative Action Center.

Additional Information : On Sunday, November 20, a New York Times article by Robert Pear addressed the difficulties physicians face with Medicare cuts at a time when their costs are rising. The article presented the view of CMS officials that doctors often respond to such cuts by performing more services, and that they should not be paid more unless they cooperate with efforts to measure the quality of the care they provide. The article also addressed the efforts of lawmakers in presenting bills meant to prevent the cuts, and the economic realities faced by physicians with a high percentage of Medicare patients. Go to http://www.nytimes.com/2005/11/20/national/20docs.html to access the article. (Registration required).