Psychiatric News May 6, 2005
Volume 40 Number 9
© 2005 American Psychiatric Association
p. 1
M.D.s Told To Expect Medicare Fees To Plunge
Mark Moran
APA and the AMA reiterate their opposition to what the two groups have
long called "a flawed payment formula."
The federal Centers for Medicare and Medicaid Services (CMS) is estimating
that average overall physician fees for doctors participating in Medicare will
drop by 4.3 percent in 2006, and over the following six years payments are
projected to dive by 26 percent.
In a recent letter to the Medicare Payment Advisory Commission, Herb B.
Kuhn, director of the Center for Medicare Management at CMS, noted that the
projected decrease in physician payments is tied to rapidly rising costs for
services paid for by the program, particularly those related to treatment of
chronic conditions.
Kuhn wrote that "the major contributors to the rapid increase in
spending appear to be certain diagnostic and therapeutic services, including
services particularly important in the treatment of chronic illnesses: more
frequent and more intensive follow-up visits, more frequent and more complex
imaging, more frequent and more intensive minor procedures such as physical
therapy, more frequent and more complex laboratory tests, and increased use of
drugs in physicians' offices."
Nicholas Meyers, director of APA's Department of Government Relations, said
the projected pay cut reflects permanent flaws in the government's formula for
paying doctors.
"The recurring threat of substantial reductions in the Medicare
payment update is a problem for all physicians and other health
professionals," Meyers told Psychiatric News. "This is
especially true for psychiatrists, who because of the nature of the services
they provide—which are bound mostly by time—are impacted the most
by the flawed payment formula.
"Congress must evaluate the current payment formula and take action
to fix the problem permanently rather than postponing it a year or two at a
time," Meyers said. "We will continue to work with the AMA and the
rest of medicine to achieve this goal."
The AMA again voiced its longstanding opposition to a payment formula that
ties payment to the amount of services rendered.
"These cuts present a serious threat to access to care for
seniors," said J. James Rohack, M.D., chair of the AMA Board of
Trustees, in a press release. "No senior citizen should have to worry
whether [his or her] physician can afford to accept Medicare patients, but if
these steep cuts go into effect, physicians may have to make hard choices
about taking new Medicare patients.
"Congress and the administration must act now to replace the flawed
physician payment formula, which penalizes physicians for providing necessary
care to Medicare patients," Rohack continued.
"Medical advances such as research breakthroughs, innovations in
technology and a focus on preventive care are improving the health of
America's patients, but they are also increasing the number of medical
services seniors need. New treatments to fight cancer and prevent blindness
have improved the quality of life for millions of elderly and disabled
Americans. Physicians should not be penalized for these successes."
More information is posted on the CMS Web site at
<www.cms.hhs.gov/physicians/medpac.pdf>.
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