Though Congress is in recess until July 8, the battle rages on over how to fund a potential physician payment fix needed to forestall a 10.6 payment cut for physicians participating in Medicare that was to take effect on July 1.
The debate over how to fund the fix is focused on the Medicare Advantage (MA) program, provided through private healthcare programs contracting with Medicare. Many Republicans oppose the Democrats' proposal to cut funding to MA to pay for the fix. The current bill on the table, H.R. 6331, would stall the payment cut for 18 months and provide a 1.1 percent increase in 2009.
America's Health Insurance Plans has launched a new nationwide cable television advertising campaign to defend MA and remindi Congress "what's at stake for millions of seniors across the country should Medicare Advantage face funding cuts."
"Congress needs to address the physician payment issue without putting seniors at risk," said Karen Ignagni, President and CEO of AHIP. "Medicare Advantage cuts could mean limited choices, reduced benefits and higher out-of-pocket costs for seniors."
The Coalition for Medicare Choices, with some 400,000 members, has called for seniors to lobby Congress over the July recess to oppose cuts to MA.
"My Medicare Advantage plan has always been there when I needed it the most," said Joe Cameron of Fort Worth, Texas, a member of the coalition. "Congress needs to know that while my healthcare benefits may not be that important to them, they are important to me."
AHIP officials said a recent poll of Medicare seniors showed a 3-to-1 ratio among traditional Medicare enrollees and a 6-to-1 ratio among Medicare Advantage enrollees who oppose cutting Medicare Advantage instead of payments for doctors who treat Medicare patients.
Additionally, the survey found that by more than a 5-to-1 ratio among traditional Medicare enrollees and a 13-to-1 ratio among Medicare Advantage enrollees, seniors prefer cutting other programs besides Medicare Advantage or raising taxes to offset the spending needed to stop a scheduled cut in physician payments.
Scott Johnson, MD, an anesthesiologist from Midtown Anesthesia Consultants, PLLC, said his current payments barely exceed his costs to provide services.
"This is a sad situation but one that we have not created and we will not pay more to provide services than we get reimbursed," he said. "At the current reimbursement rates there is no room left for cuts, we have given all that we can – and then some – so any further cuts to reimbursement for anesthesiologists will result in cuts to services provided to Medicare patients and possibly cessation of all services for Medicare patients."
On Monday, Sens. John Rockefeller (D-W.V.) and Charles Schumer (D-N.Y.) called the Bush Administration's temporary hold on pay cuts from July 1 to July 15 a farce. In a June 30 letter to Department of Health and Human Services Secretary Michael Leavitt, the senators said physician claims submitted electronically are already required by law to be held 13 days prior to payment.
They urged Republican senators, who effectively blocked passage of a physician payment fix last week, to compromise on their unwillingness to cut funding to MA and pass the proposed bill after July recess.
"The way the administration can truly help doctors in the Medicare program is to stop protecting the profits of health insurers," Rockefeller and Schumer said.