A bipartisan bill that provides for increases in Medicare physician payment is a good start to solving Medicare reimbursement issues, according to AAFP President Mary Frank, M.D., of Mill Valley, Calif.
The legislation, the Preserving Patient Access to Physicians Act of 2005, was introduced in mid-May as S.1081 in the Senate by Sens. Jon Kyl, R-Ariz., and Debbie Stabenow, D-Mich., and as H.R. 2356 in the House by Reps. E. Clay Shaw Jr., R-Fla., and Benjamin Cardin, D-Md.
AAFP President Praises Bill to Update Medicare Payments
By Leslie Champlin
5/23/2005
"This bill is important because it will provide some stability in physician Medicare payment rates," said Frank. "With such stability, family physicians will be able to continue to provide high-quality care for America's seniors and disabled patients."
Without such legislation, physicians would see a 4.3 percent cut in Medicare payment in 2006 and as much as 26 percent in reductions over the following five years.
If passed, the bill would override the sustainable growth rate formula that currently determines Medicare payment rates to physicians and would increase Medicare payment by 2.7 percent in 2006. In subsequent years, the increase would reflect physicians' practice costs and inflation, expected to be about 2.6 percent, Frank said in an AAFP statement about the bill.
"This is certainly not the complete answer to the Medicare problem, but it is a significant step forward," said Frank of the proposed legislation.
AAFP has called on Congress to pass a law that implements recommendations by the Medicare Payment Advisory Commission. Among those recommendations: Drop the SGR formula in favor of one that more closely reflects physicians' actual cost of doing business.
The idea has garnered some support on Capitol Hill. Noting "the Medicare physician payment formula is fundamentally flawed," Stabenow said in a statement on the bill's introduction. "We cannot continue to use stop-gap measures but must replace the SGR with a payment system that actually makes sense and reflects the costs of providing physician care to Medicare beneficiaries, he said."
Kyl agreed. "This formula is not doing what it was intended to do," he said. "Therefore, I believe we need to scrap it and start again. … I would really like to see us go all the way back to the drawing board and answer the fundamental question of how to pay physicians appropriately for their services."
Faced with an ongoing decline in Medicare payment, physicians would be forced to limit the number of Medicare beneficiaries they could see, according to Frank.
"That declining reimbursement rate would likely mean a growing percentage of family physicians would decline to see new Medicare patients and, as a result, access to care would suffer," she said. "This helps keep the Medicare program strong for those who need it most -- America's seniors and disabled patients."
Without such legislation, physicians would see a 4.3 percent cut in Medicare payment in 2006 and as much as 26 percent in reductions over the following five years.
If passed, the bill would override the sustainable growth rate formula that currently determines Medicare payment rates to physicians and would increase Medicare payment by 2.7 percent in 2006. In subsequent years, the increase would reflect physicians' practice costs and inflation, expected to be about 2.6 percent, Frank said in an AAFP statement about the bill.
"This is certainly not the complete answer to the Medicare problem, but it is a significant step forward," said Frank of the proposed legislation.
AAFP has called on Congress to pass a law that implements recommendations by the Medicare Payment Advisory Commission. Among those recommendations: Drop the SGR formula in favor of one that more closely reflects physicians' actual cost of doing business.
The idea has garnered some support on Capitol Hill. Noting "the Medicare physician payment formula is fundamentally flawed," Stabenow said in a statement on the bill's introduction. "We cannot continue to use stop-gap measures but must replace the SGR with a payment system that actually makes sense and reflects the costs of providing physician care to Medicare beneficiaries, he said."
Kyl agreed. "This formula is not doing what it was intended to do," he said. "Therefore, I believe we need to scrap it and start again. … I would really like to see us go all the way back to the drawing board and answer the fundamental question of how to pay physicians appropriately for their services."
Faced with an ongoing decline in Medicare payment, physicians would be forced to limit the number of Medicare beneficiaries they could see, according to Frank.
"That declining reimbursement rate would likely mean a growing percentage of family physicians would decline to see new Medicare patients and, as a result, access to care would suffer," she said. "This helps keep the Medicare program strong for those who need it most -- America's seniors and disabled patients."
