November 05, 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.
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.
all, total cuts to Medicare payments in the emerging Senate bill could
be significant, totaling hundreds of billions of dollars.
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.
Use CapWiz to contact your Senators now