Doctors face payment cuts for Medicare
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WASHINGTON -- Dr. James King, a physician in Selmer, Tenn., doesn't take new Medicare patients. More physicians may do the same if Congress cannot find a way to block a scheduled July 1 cut in Medicare fees, he said.
With physician reimbursements set to drop 10 percent next week, doctors will begin evaluating whether to stay in the U.S. health insurance program for the elderly and disabled, said Dr. King, 53, president of the American Academy of Family Physicians. His practice stopped accepting new Medicare patients last year, when cuts were last under consideration.
Senate Republicans blocked action Thursday on Democratic-backed legislation that would have averted the fee cut, by reducing payments instead to insurers that provide benefits through plans called Medicare Advantage. Republicans said the insurer cuts -- which the House had already approved -- were too deep, and that the Bush administration had threatened to veto the measure. Now, Congress is scheduled to be in recess until July 7.
"The Senate's got to come back and do something to prevent the 10 percent cut," Dr. King said in a phone interview yesterday. "Each senator has a responsibility, and, if they felt this was important, they should have passed it with enough votes to override."
Democrats will reintroduce the measure in the Senate when they return from the July 4 holiday weekend, Senate Majority Leader Harry Reid, D-Nev., said in an e-mailed statement yesterday.
Health insurers rose in trading after Congress left Medicare Advantage unscathed. Humana Inc. of Louisville, the publicly traded insurer most dependent on Medicare, increased $1.24, or 3.1 percent, to $41.27 at 4:03 p.m. in New York Stock Exchange composite trading. The six-member Standard & Poor's 500 Managed Health Care Index rose 1 percent.
The proposed legislation also would have expanded assistance for low-income seniors, lowered co-payments for mental health treatment and postponed Medicare's introduction of competitive bidding for medical equipment. On June 24, the measure passed the House, 355-59 -- enough to override a veto.
Senate Republicans and Democrats agreed that they needed to stop the cut in physician payments. They disagreed about how to pay for it, with Democrats seeking deeper reductions in reimbursements to UnitedHealth Group Inc., WellPoint Inc. and other private insurers that provide Medicare Advantage plans.
Medicare's fee for an average office visit is $59.80, with beneficiaries responsible for 20 percent, according to the program. The cut in fees, required under a complex formula that Congress set a decade ago to hold down spending, will put more pressure on physicians who already feel that their reimbursements are low, Dr. King said.
"Senators who voted against the Medicare bill last night just voted wrong," Senate Finance Committee Chairman Max Baucus, D-Mont., said in an e-mailed statement yesterday. "I'll keep fighting for all these good policies for seniors in the coming weeks."
The legislation would have reduced payments to Medicare Advantage by removing money linked to the extra cost of treating patients at teaching hospitals. Hospitals already receive separate payments to cover this, and that fact wouldn't have changed, according to the measure.
So-called private fee-for-service plans in Medicare Advantage would have been required to contract in advance with providers to treat the plan's enrollees. The two changes would have saved about $12.5 billion over five years, according to the Congressional Budget Office.
Insurers in Medicare Advantage are paid, on average, 13 percent more than Medicare spends to provide benefits, according to congressional analysts.
The changes in fee-for-service plans would have reduced beneficiary access to the coverage and services, the Bush administration said in a statement yesterday on the threatened veto.
First Published June 28, 2008 12:00 am
