Medicare Reform Includes 2-Year Fee Schedule Fix: Medicare Drug Law Blocks 4.5% Cut in 2004

By Silverman, Jennifer; Schneider, Mary Ellen | Clinical Psychiatry News, January 2004 | Go to article overview

Medicare Reform Includes 2-Year Fee Schedule Fix: Medicare Drug Law Blocks 4.5% Cut in 2004


Silverman, Jennifer, Schneider, Mary Ellen, Clinical Psychiatry News


WASHINGTON -- Physicians have 2 more years to lobby for a permanent legislative fix to Medicare's flawed reimbursement formula.

The historic $400 billion Medicare overhaul/prescription drug bill (H.R. 1) blocked a projected 4.5% cut to physician reimbursement in 2004 and provided payment increases of not less than 1.5% in 2004 and 2005.

The bill was approved by both houses of Congress in late November and signed in early December by President Bush.

The legislation "buys us 2 years to try to get a permanent fix enacted," Bob Doherty, senior vice president for governmental affairs and public policy at the American College of Physicians, told this newspaper. It does not actually correct the flaw in the fee schedule's formula, which cuts payments whenever the costs of Medicare services exceed growth in the economy.

In a letter to Senate Majority Leader Bill Frist (R-Tenn.), the American College of Obstetricians and Gynecologists encouraged Congress to find a long-term solution to the Medicare payment formula, to ensure stable payments in the future.

"ACOG understands that budgetary constraints only allow for a short-term fix to the flawed physician payment issue," ACOG Executive Vice President Ralph Hale wrote. "However, we remain deeply concerned about the deep cuts in payments slated after 2006."

It is more likely, however, that nothing will be done until 2005, as "Congress won't want to take up Medicare next year," Mr. Doherty predicted. The ACP, in the meantime, will continue to lobby for a fix, he said.

"When it costs more to see a patient than what you are paid, it's hard to keep the doors open," Dr. Donald Palmisano, president of the American Medical Association, said in praise of the bill.

"By strengthening rural health care, halting the planned Medicare pay cuts, and reducing Medicare's regulatory burdens, more physicians will be able to continue to participate in Medicare--and seniors will not have to worry about finding a doctor when they need one," Dr. Palmisano said.

Physician groups will continue to press the Centers for Medicare and Medicaid Services to remove Medicare-covered out-patient drugs from the Sustainable Growth Rate, a component of the physician fee formula. The AMA estimates that eliminating these drugs from the formula could add $25 billion to $80 billion to expenditures for physician services over the next 10 years.

In other payment relief provisions, the huge Medicare reform bill eliminated any reductions to Medicare reimbursements that occur as a result of geographic adjusters, such as local variations in labor, practice, and medical liability insurance.

Measures to enhance preventive care services under Medicare also were included in the bill:

* A "welcome to Medicare" initial physical examination will be offered to new beneficiaries, although it was not known at press time how it will be reimbursed.

* Screenings for early detection of cardiovascular disease and laboratory screening for individuals at high risk for diabetes will be covered, as will more disease management programs for Medicare beneficiaries. While many provisions of the reform legislation directly impact physicians, a major part--the Medicare prescription drug benefit--mostly impacts patients.

Under a new voluntary program--known as Medicare Part D--coverage will involve:

* A $35 average monthly premium.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Medicare Reform Includes 2-Year Fee Schedule Fix: Medicare Drug Law Blocks 4.5% Cut in 2004
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.