Doctors ask Congress to avert Medicare reimbursement cut


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Posted Online: Dec. 11, 2012, 5:54 pm
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By Eric Timmons, etimmons@qconline.com
Doctors are facing a fiscal cliff of their own on Jan. 1 when the amount they are paid to serve Medicare patients could be cut by 29 percent.

Every year since 2003, Congress has deferred implementing the Sustainable Growth Rate formula to calculate payment rates for doctors through Medicare, a government-run insurance program that covers seniors and the disabled.

Dr. William Werner, president of the Illinois State Medical Society, said the cutback would reduce payments to doctors by 27 percent next year.

That's compounded by automatic spending reductions that are part of the fiscal cliff and include a 2 percent cutback to Medicare, for a total of 29 percent.

"We're looking at almost a 30 percent cut in reimbursements for doctors from Medicare," Dr. Werner said. "If you looked at any other business or profession, a 30 percent cut to one of your major sources of income is significant."

According to the American Medical Association, the 27 percent cut in reimbursements from Medicare would reduce revenues to medical practices in Illinois by an average of $31,000 in 2013.

Congress so far has managed to avoid introducing the SGR formula, sometimes waiting until after Jan. 1 to do so, Dr. Werner said during a Tuesday meeting with the editorial board of The Dispatch/Rock Island Argus.

U.S. Rep. Bobby Schilling, R-Colona, later said by phone that he expects Congress will pass another temporary "doc fix" to prevent a steep reduction in the Medicare reimbursement rate.

"This is something they've been kicking down the road for way too long," Rep. Schilling said. "They are trying to balance all of the problems on the backs of the doctors."

A solution could come during the lame duck session this month before Rep. Schilling leaves office. Congresswoman-elect Cheri Bustos will be sworn in next month.

Rep. Schilling said he was concerned that uncertainty about the future of Medicare could lead doctors to not to take on new Medicare patients.

The Sustainable Growth Rate formula was part of a deficit reduction law in 1997 to calculate Medicare payments to doctors to control growth in the cost of Medicare.

The proposed cut in Medicare reimbursements has compounded every year Congress has deferred action. In 2002, the proposed cut was around 5 percent, a number that has now risen to 27 percent from Jan. 1, unless Congress again passes a temporary fix.

The Illinois Medical Association is among the groups calling for a permanent solution to the SGR impasse.

The nonpartisan Congressional Budget Office has estimated it would cost the government $11 billion in 2013 and $18 billion in 2014 if reimbursement cutbacks are again averted and Medicare rates stay the same.


















 



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