House Leaders Urged to Avert A Medicare Physician Access Crisis

In a letter to US House leaders, the NCMS has joined with other state medical societies, the AMA and national specialty organizations in asking Congress to act in early November to avoid a pending 23% cut in Medicare and TRICARE physician payments. The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 stabilized Medicare physician payments until November 30, 2010. The proposed cuts would take effect December 1, with an additional cut of 6.5% scheduled for January 1, 2011.

The organizations want Congress to find a permanent solution to the sustainable growth rate (SGR), the formula used to determine Medicare physician payments, and replace it with a system that can keep pace with the cost of caring for seniors. Thus far, Congress has chosen to delay cuts using short-term, stop-gap measures.

The letter notes that the next payment reduction comes “during the period when physicians may change their status from a Medicare participating physician, who accepts Medicare’s allowance as a payment in full, to a non-participating physician who may bill patients more than the Medicare allowance.” The perpetual uncertainty regarding Congressional support for the Medicare program has caused many physicians to either leave the Medicare program or restrict the number of Medicare patients they see. This poses a risk to access for seniors, especially in rural areas where smaller practices often serve a larger than average number of Medicare patients and cannot afford large cuts in Medicare physician payments.

The NCMS is urging its members to contact their US Representatives and Senators today and urge them to act in the first week of the lame-duck session of Congress to avert a Medicare physician access crisis.

You can see how your representative and your senators have voted on the SGR issue in the past.


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1 Comment

  • I work in a specialty practice that is
    about 65% Medicare. Due to cuts in reimbursement from all payors, we struggle to
    pay our bills each month. Imagine that over one
    half your business comes from Medicare and your
    practice is already struggling. I fear that we
    will not be able to continue at this rate.
    Reimbursement is going down, but costs for
    everything else are going up. Congress needs to
    do something if they really want our Medicare
    population to be taken care of..Something this
    important should not be put on the back burner.
    Perhaps, all federal employees that are Medicare age should be on Medicare and not
    the Federal Plan and have to seek care from a
    Medicare provider (if they can find one)