AMA Seeks Delay in Medicare Payment Cuts

Doctors would be forced to limit number of older patients, group contends

Steven Reinberg

Steven Reinberg

Updated on September 08, 2006

THURSDAY, Sept. 7, 2006 (HealthDay News) -- If proposed cuts in Medicare payments to physicians take effect early next year as planned, many U.S. doctors would be forced to limit the number of older Americans they can see as patients, the American Medical Association said Thursday.

However, Congress seems likely to postpone the cuts for at least one more year. Eighty senators have signed a letter to the Senate leadership, asking that the cuts to doctors be delayed.

At issue is the soaring cost of Medicare, the federal health insurance program for people 65 and older, as well as some other, younger Americans with certain disabilities. It's estimated that Medicare will cost taxpayers $420 billion in 2006, up from $335 billion in 2005. And that figure is projected to soar to $792 billion in 2015, according to a recent study published in Health Affairs.

In seeking ways to limit the explosive spending growth, Congress is considering a variety of measures, including limiting reimbursement payments to doctors.

"On Jan. 1, the federal government will begin nine years of cuts totaling nearly 40 percent of the payments made to physicians who care for Medicare patients," AMA board member Dr. William Hazel Jr. said during a teleconference Thursday afternoon.

The hope is that Congress will come up with a reimbursement formula acceptable to doctors, without overwhelming taxpayers, Hazel said. But a new formula will take time to develop. So, the AMA would like to see any reimbursement cuts postponed for up to two years to provide the needed time to create a new payment plan, he said.

The AMA worries that the proposed cuts in reimbursements to doctors would prevent patients from seeing doctors in a timely way, because the cuts would force many doctors to stop seeing or delay seeing Medicare patients, Hazel said.

"This concern is matched by many in Congress, the Federal Advisory Committee on Medicare and now the vast majority of Americans," Hazel said. According to a new AMA survey, 86 percent of people are worried that cuts to doctors would hurt their ability to get care. This was true for 86 percent of patients already receiving Medicare, and 96 percent of Baby Boomers, he said.

What's more, the majority of people aren't aware of the pending reimbursement reductions to doctors. "Seven out of 10 Americans are unaware that the government plans to make these cuts," Hazel said.

Among doctors questioned in a previous AMA survey, half said they would stop taking on new Medicare patients or reduce the number of Medicare patients they see if next year's cuts take place, Hazel said. "Over the life of the cuts, 67 percent said they would be forced to decrease or stop taking on new Medicare patients," he said.

Hazel said he hopes Congress will act in the next three weeks, before recessing, to postpone the cuts -- as it has done for the last several years.

One expert thinks the cuts will be delayed, if not in the next few weeks, then when Congress returns after the mid-term elections in November.

"Congress realizes this is an important issue, and they want to address it," said Mary R. Grealy, chairwoman of Medicare Today and president of the Healthcare Leadership Council, an industry lobbing group.

"They will probably do a one-year fix," Grealy said. "Every year, it gets done. We are pretty certain it will get done again this year. The question is when. It could be done in the next couple of weeks, but if it's not, it will be done during the lame-duck session."

Meanwhile on Thursday, two new national surveys conducted by the Kaiser Family Foundation found that substantial majorities of pharmacists (86 percent) and physicians (71 percent) believed that the new prescription drug law was helping people on Medicare save money on medications, although both professional groups said the law was too complicated.

Eight in 10 pharmacists (81 percent) said that they had had customers who had problems getting their prescriptions and one in five (19 percent) reported such problems had affected most of their customers in Medicare drug plans. In addition, the surveys found, two in three pharmacists (67 percent) said they had had customers leave the pharmacy without a medication because the prescribed drug was not on their Medicare drug plans formulary.

More information

The American Medical Association lists Medicare physician payment reform among its legislative priorities.

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