Doctors fighting Medicare fee reduction

The president of the American Medical Association is calling on Congress to postpone a 25 percent cut to doctors in their Medicare payments that the association says could force physicians to stop treating seniors.

The Sustainable Growth Rate, created in 1997 as part of the Balanced Budget Act, was meant to control federal health care costs by reducing physician fees per patient as the number of Medicare patients grew, said Dr. Fred Hyde of the Columbia University School of Public Health. But each time cuts were supposed to be implemented, Congress either raised physician fees or kept them the same, Hyde said.

This year, however, Congress abandoned the strategy of passing one-year fixes and passed short-term postponements for a few months at a time. As a result, a Dec. 1 deadline that would impose a 23 percent cut on doctors' reimbursements looms. As of Jan. 1, an additional 1.9 percent cut would go into effect if Congress doesn't take action.

The AMA's president, Dr. Cecil Wilson, speaking at a national AMA meeting in San Diego Monday, said that doctors were losing their confidence in Medicare and he called on Congress to postpone the cuts for at least 13 months and find a permanent solution.

"The roller coaster ride caused by Congress' inability to stop the cut for at least a year is eroding physicians' confidence and commitment to Medicare," Wilson said. He said that about 1 in 5 doctors have said they have limited the number of Medicare patients in their practice because of the threat of cuts and already low Medicare payments.

Nearly a million physicians and other medical practitioners would be affected by the cuts, according to the federal Centers for Medicare & Medicaid Services.

The head of the Medical Society of the State of New York, Dr. Leah McCormack, a dermatologist in Forest Hills attending the San Diego meeting, said she decided this past October to no longer take Medicare reimbursements even though about 40 percent of her patients are seniors. Instead, she said, she is willing to accept lower payments to avoid the uncertainty of Medicare rates as well as the "constant aggravation" of dealing with the federal bureaucracy.

"I finally had it with Medicare," she said.

U.S. Health and Human Services Secretary Kathleen Sebelius said she backed the AMA's proposal. She also said President Barack Obama supported preventing the cuts, as does the AARP, the Manhattan-based Medicare Rights Center and many local lawmakers. In fact, the debate appears not to be centered on whether it is good policy to cut seniors' benefits, but rather how to pay for them, officials said.

"The single biggest step we can take to strengthen Medicare for seniors and disabled Americans is to make sure these disruptive cuts don't take effect," Sebelius told those attending the Association of American Medical Colleges annual meeting Monday.

The problem is finding the money, which is why a bill to change the Sustainable Growth Rate passed the House last year but died in the Senate, said Moe Auster, counsel to the division of government affairs for the Medical Society of the State of New York.

A 13-month postponement would cost up to an estimated $20 billion, while a long-term solution would cost up to $374 billion over 10 years, according to the U.S. Congressional Budget Office.

Sen. Charles Schumer (D-N.Y.) called the cuts "unfair" and said he strongly supported "postponing these cuts and putting in place a permanent fix."

Sen. Kirsten Gillibrand (D-N.Y.) agreed: "I will work hard with my colleagues, of both parties, to make sure we prevent Medicare cuts that could hurt Long Island seniors," she said.

Rep. Carolyn McCarthy (D-Mineola) said preventing the cuts "encourages more doctors to participate in the Medicare program, providing more options and access for Long Island seniors."

Rep. Steve Israel (D-Huntington) said he supported a long-term solution: "Doctors need consistency to run their businesses and patients need to trust that they'll have access to their doctors."