Returning senators can expect an earful on Medicare 'doc fix'

Senators returning from the Memorial Day recess can expect to be under intense pressure from their elderly constituents worried about losing access to their doctor.

A steep cut in Medicare payments to physicians will go into effect shortly unless the Senate acts to prevent what physicians’ groups are warning could be the unraveling of the nation’s healthcare program for the elderly.

“We’re asking them to stop this year’s cut before there’s a complete Medicare meltdown,” James Rohack, president of the American Medical Association (AMA), said in a conference call this week with reporters. “And we’re saying bring some sanity back to the system: Fix the [Medicare payment] formula before you create a hole that’s too deep to climb out of.”

The doctors group is pressing seniors to call their senators and urge them to approve legislation preventing a 21.3 percent cut to Medicare payments. AMA on Thursday launched a multi-million dollar TV, radio and print ad campaign on the issue.

The House approved legislation delaying the cut for 19 months and giving doctors slight pay bumps in 2010 and 2011, but the Senate balked at the $23 billion price tag and didn’t vote before the recess.

The agency that oversees Medicare however has asked contractors to postpone processing claims for 10 business days, the third time this year that the agency has had to give lawmakers time to retroactively block the cut.

That means the Senate has about a week to take action before the cuts go into effect.

The AMA wants Congress to not only prevent the cut but also scrap the Medicare payment formula known as the Sustainable Growth Rate. This is the fourth cut scheduled this year that Congress has had to prevent – it was postponed until Jan. 1, then March 1, then April 1 and now June 1.

Along with the ads, the AMA is releasing an online survey of more than 9,000 physicians showing that the short-term fixes are not sustainable.

While 17 percent of the respondents said they already restrict the number of Medicare patients in their practice, mostly because they think the payment rate is too low, more than half – 54 percent – said they would do so if Congress postpones the cut for just four to seven months. Fifty percent said such a short-term fix would lead them to stop taking new Medicare patients, and 31 percent said they’d stop taking any Medicare patients.

The respondents also said they’ve already cut back this year because of the program’s instability: 60 percent said they’ve looked into opting out of Medicare; 39 percent said they’ve delayed payments for supplies, rent and other expenses; and 17 percent said they’ve held up paychecks or laid off or furloughed staff.

Rohack said the scheduled cut will also hurt physicians’ ability to invest in health information technology and quality-boosting initiatives such as care coordination, which are important goals of health reform.

The group is launching the ads in 17 states, many of which already face Medicare access problems; they are: Arizona, Florida, Georgia, Illinois, Iowa, Maine, Massachusetts, Missouri, Nevada, North Carolina, Ohio, Oregon, South Dakota, Tennessee, Texas, Virginia and Wisconsin. In addition, the AMA is placing ads in three national newspapers: The New York Times, The Wall Street Journal and USA Today.

Rohack said the AMA is not targeting specific lawmakers because all lawmakers need to take responsibility. He added that the longer Congress delays a comprehensive fix, the more costly it gets: It would have cost $49 billion to do the fix in 2005, and more than $200 billion today.

“The cost of a temporary solution,” Rohack said, “now significantly exceeds what it would have cost to implement a permanent solution just a few years ago.”