Pharma Strategy Blog

Commentary on Pharma & Biotech Oncology / Hematology New Product Development

With Medicare reimbursement rates to physicians set to drop by more than 20 percent Monday, Vicksburg physician Randy Easterling, president of the Mississippi State Medical Association, is warning that elderly patients could find themselves with no doctor able to afford to treat them.

Easterling said the 21.2 percent decrease in Medicare reimbursements to doctors will automatically go into effect Monday unless Congress votes to stop it.

“They didn’t vote to stop it last night (Thursday night),” Easterling said Friday. “Maybe they’ll do it this weekend, but if they don’t, doctors won’t be able to see these patients.”

The U.S. House passed H.R. 4691, a “Temporary Extension Act,” Thursday, postponing the reimbursement cuts until the end of the month, but the measure, tied to other legislation, did not pass in the Senate. The Senate adjourned just before noon Friday and wasn’t expected to reconvene until Monday afternoon, according to a floor schedule on the Senate’s Web page. The site indicated no votes had been cast.

A domino-effect could also impact the state’s low-income patients on Medicaid, because Mississippi Medicaid reimbursement is a percentage of Medicare, Easterling said. If one goes down, so does the other.


Impact of Medicare reductions:

In the past, AMA surveys have shown that the threat of reducing the reimbursement for Medicare can have several impacts:

  • Physicians have seen their profits from treating Medicare patients fall to just covering their costs, and in some cases where treatment or required tests are expensive, it would mean treating those patients at a loss.
  • Some physicians have limited the number of Medicare patients they would be willing to treat and this may increase.
  • Other physicians stopped taking Medicare patients altogether and referred them to other doctors or clinics able to take them. This too, may also increase, unless the reimbursement system is fixed rather than patched.

Of course, the AMA always threaten these actions annually and thus significant lobbying takes place to pressure lawmakers to provide a solution, yet the system remains flawed and broken. The current Government appears to recognise this, but has been unable to broker a solution and is mired in partisan bickering.

Ultimately, a new plan may emerge in 2010 as part of the ongoing health care reform, but so far, a bipartisan agreement has not been possible to attain. Any proposals being reviewed now may not be the final form that is eventually enacted as law.

The next 10 days may well determine what happens with Medicare reimbursement this year and are likely to have a significant impact on areas such as cardiology and oncology.

Posted via web from sally church's posterous

One Response to “Doctors' Medicare refunds may drop 20 percent Monday”

Comments are closed.

error: Content is protected !!