November 5, 2009

 

U.S. Senate considering legislation that includes massive cuts to physician payments

Senate Leadership is working to craft the chamber’s final health care reform bill.  In merging proposals adopted by the Senate Finance and Health, Education, Labor and Pensions (HELP) Committees, it has become apparent that proposed physician payment reductions will be used to heavily finance many of the bill’s reforms.  ASA is extremely concerned about the impact of those proposed cuts on already unreasonably low Medicare payments for anesthesia services.

Proposals pending in the Senate include the potential for drastic reduction through four mechanisms:

• “Independent Medicare Advisory Commission” (IMAC): A new entity with the power to implement across-the-board Medicare payment reductions expected within a few years;
• “Resource utilization outlier” provisions: Target physicians who are perceived to be using excessive “resources” for patient care without regard for patient acuity or complexity of care required.  For anesthesiology, the most complex cases would likely receive a 5 percent across-the-board reduction.
• Physician Quality Reporting Initiative (PQRI) punitive component: No longer voluntary and would expose physicians to  payment penalties; and
• “Budget neutral” physician payment changes: Would mean across-the-board payment reductions to support bonus payments to primary care physicians and rural general surgeons.  

Further compounding these newly-proposed reductions, Senate legislation neglects to provide meaningful reform to the Sustainable Growth Rate formula (SGR), under which all physicians face a 21 percent Medicare payment cut beginning in January 2010. 

In all, total cuts to Medicare payments in the emerging Senate bill could be significant, totaling hundreds of billions of dollars.

Please urge your Senators to reject these Medicare payment reductions, and to instead support provisions that appropriately compensate physicians for the care they provide to America’s patients.

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