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ORGANIZATIONS ADVOCATE CHANGE IN MEDICARE PHYSICIAN PAYMENT FORMULA

Last week, AARP, along with five other consumer and professional organizations, sent a letter to leaders in Congress, urging them to protect access to health care for people with Medicare by addressing the flawed Medicare physician payment formula. Without congressional action, a 27.5 percent cut in payments to physicians treating Medicare beneficiaries will take effect on January 1, 2013. Here is a copy of the letter that was sent:

“Dear Chairman Baucus, Ranking Member Hatch, Chairman Upton, Ranking Member Waxman, Chairman Camp, and Ranking Member Levin:

“The undersigned organizations, representing health care providers, clinicians, and Medicare beneficiaries, write to urge Congress to avert looming payment cuts to the providers who millions of older adults and people with disabilities rely on for care. The Medicare physician payment formula is long overdue for reform in order to ensure stable access to health care for people with Medicare. We need to move away from the current payment formula that year after year relies on congressional action to postpone scheduled payment cuts, including a drastic 26.5 percent cut scheduled to take effect beginning January 1, 2013.

“Congress has long recognized that the Sustainable Growth Rate (SGR) is a poor method for establishing payment rates for health care providers paid under the Medicare physician fee schedule. In each of the last ten years it has voted to override the cuts mandated under the formula. These stop-gap measures have served to increase the size of future cuts, the cost of long-term reform, and the insecurity among people with Medicare about their ability to maintain access to their doctors. We urge you to pass the longest possible SGR fix this year, in order to allow for the development of a long-term and sustainable solution. New payment methods are needed that maintain access and encourage the delivery of high-quality care.

“Addressing the current flawed payment formula is a necessary and far-sighted course of action. Congress has an opportunity to repeal the SGR — the first step toward enacting a better payment system — by redirecting money from the Overseas Contingency Operations (OCO) fund the Pentagon says will never be spent. Each of the organizations signing onto this letter supports the use of OCO in the final package.

“As we address this problem, we must also be sure to keep the Medicare program affordable for beneficiaries, especially given that today the typical older person relies on less than $22,000 a year and spends over 15 percent of his/her income on health care. Therefore, we must avoid imposing any additional costs of SGR reform on beneficiaries. We also urge a continued focus on improving the quality of care for older adults and the disabled, including access to primary care services and care coordination, which are key to achieving the goals of better care, better health, and lower costs.

“The annual legislative struggle to avert Medicare physician payment cuts has gone on far too long. It is crucial to ensure that people in Medicare can maintain relationships with the doctors and providers who treat them. Our organizations are ready to work with you to help all members of Congress to address this issue, which is vitally important to the older adults and people with disabilities across the nation.”

In addition to AARP, the letter was signed by the American Academy of Family Physicians, the American College of Physicians, the American Geriatrics Society, the Center for Medicare Advocacy, Inc. and the Medicare Rights Center.

For more information, please contact Joel M. Greenberg, Esq. at (516) 492-3390, or visit The HLP Website.

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