4 articles showing progress in movement to stop MEDICARE reimbursement cuts
CAL/AAEM News Service
pottsbri@yahoo.com
Fri, 31 Jan 2003 15:38:14 -0800 (PST)
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-----Original Message-----
From: AAEM [mailto:info@aaem.org]
Sent: Wednesday, January 29, 2003 8:28 AM
Subject: Medicare Provider Payments
To AAEM members,
Good news from Washington.
AAEM Washington Update:
The Senate late Thursday (1/23) agreed to an amendment to use $900 million in the FY 2003 omnibus spending bill to prevent a 4.4% cut in Medicare payments to physicians. If the House agrees to this action during the Conference to be held to iron out the differences between the Senate and House bills, the physician payment reduction scheduled to take effect March 1 will not occur.
AAEM 611 East Wells Street Milwaukee, WI 53202
800-884-2236 Fax: 414-276-3349
E-mail: info@aaem.org website: www.aaem.org
================================================
Senate passes bill to stop Medicare fee cut
Measure effective until Sept. 1, gives Congress time to make permanent changes
By Leigh Page <mailto:lpage@crain.com>
Jan 24, 2003
After months of frenzied physician lobbying and false starts, the U.S. Senate on Thursday night finally passed legislation to cancel a planned 4.4% reduction in Medicare physician fees for the next six months.
The measure, part of Congress' $390 billion appropriations bill and effective until Sept. 1, is now almost certain to pass, allowing Congress time to make permanent changes, say lobbyists for physicians' organizations in Washington, D.C..
"This is fee freeze, not a fee fix," says Priscilla Perry, M.D., chair of the government relations committee of the American Society of Cataract and Refractive Surgery, part of a coalition of specialty societies that has lobbied against the fee cuts.
"We very much appreciate the Senate being willing to take these steps, which will give some time to work on what we feel is the underlying problem: a deeply flawed payment formula," Perry adds.
The Senate passed the appropriations bill with the fee freeze in it at around 9 p.m. EST Friday, according to Nancey McCann, director of government relations, American Society of Cataract and Refractive Surgery.
McCann says the bill, which already passed the House without a fee freeze in it, now goes to a House-Senate conference committee next week after the House convenes next Tuesday.
Bush is expected to include longer-term changes for physician fees in his budget, which will be released in February, she says.
While the House last year passed a bill to avert the 2003 fee cuts, the Senate failed to follow up. Cherie McNett, director of government affairs for the American Urological Association, attributes the Senate's change of heart to the new Senate majority leader, Sen. Bill Frist (R-Tenn.).
"It's not because he is a physician; it's because he is a legislator," McNett says. "Under his leadership, I think you'll find that the Senate will move ahead with a variety of bills this year."
=====
Promising comments from Tom Scully...
Antoine Kazzi
-----Original Message-----
From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]
Sent: Thursday, January 23, 2003 10:02 AM
CMS Administrator Scully Says Bush Administration Opposes Medicare Physician Fee Cuts
01/23/2003
CMS <http://www.cms.gov/> Administrator Tom Scully yesterday said the Bush administration opposes scheduled reductions in Medicare reimbursements to physicians, "all but ensur[ing]" that the 4.4% drop in physician payment levels scheduled for March 1 will not go into effect, the <http://www.latimes.com/news/nationworld/nation/la-na-medicare23jan23,0,
1891606.story?coll=la%2Dheadlines%2Dnation> Los Angeles Times reports. Speaking at a health policy conference in Los Angeles yesterday, Scully said, "The physician thing is an emergency, and it needs to be fixed now" (Kemper, Los Angeles Times, 1/23). Earlier this month, House Ways and Means Committee Chair Bill Thomas (R-Calif.) sponsored a bill that would use the Congressional Review Act, which allows Congress to overturn regulations recently published by a federal agency, to cancel the scheduled reduction. Scully said that a bill to overturn the regulation in order to prevent the scheduled cuts also would block "other things in the rule that are essential to running the [Medicare] program" ( <http://www.californiahealthline.org/members/basecontent.asp?contentid=4
7659&collectionid=3&program=1%20> California Healthline, 1/10). Meanwhile, Sen. Charles Grassley (R-Iowa) has added a Medicare payment adjustment to the omnibus 2003 appropriations package that would freeze physician payments at 2002 levels and increase reimbursements to rural and small urban hospitals, the Times reports. However, Scully said in his remarks yesterday that the administration is only seeking to address physician payment levels, not reimbursements to other Medicare providers, adding, "The doctors' thing is a big mistake. All the other stuff can wait."
Medical Community Response
Last year, Bush's health care advisers said the president would not support higher reimbursement rates for providers without also implementing a prescription drug benefit for Medicare, but that position has "evolved significantly," according to the Times. A 5.4% reduction in Medicare reimbursement rates to physicians in 2002, combined with Congressional "deadlock" on a Medicare prescription drug plan, has prompted doctors to stop accepting Medicare patients "in droves," and many seniors are now "scrounging for care," the Times reports. The American Medical <http://www.ama-assn.org/> Association and other groups have lobbied "relentlessly" against the cuts, saying that the reductions would cause private insurers -- most of which tie their payment rates to federal levels -- to lower reimbursements, according to the Times. "It's all about access and keeping doctors afloat," Dr. John Armstrong, member of the AMA board of trustees, said, adding that he was "very pleased" with Scu!
lly's comments. Scully also indicated that President Bush in his State of the Union address next week will highlight a Medicare prescription drug benefit and tax credits for the uninsured as critical domestic issues, according to the Times (Los Angeles Times, 1/23).
==========================================
This is interesting. Look at your top 10 codes and see what your hit will be, factoring in your percentage of Medicare, which is a number you need to make the calculation of your loss due the Medicare new reduction for providers.
Elizabeth Woodcock is a well known expert in Medical Practice Management. Her perspective - on where Medicare is headed - is worth reading.
A. Antoine Kazzi, MD, FAAEM, FACEP
Vice President, the American Academy of Emergency Medicine
-----Original Message-----
From: docalerts@epocrates.com [mailto:docalerts@epocrates.com]
Sent: Thursday, January 16, 2003 6:54 PM
Subject: Requested DocAlert information about Medicare Fee Schedule
Dear ePocrates Subscriber,
Here is the information you requested from the ePocrates DocAlert system:
PRACTICE MANAGEMENT PEARLS (SM)
A Weekly Report on Practice Management Issues
By Elizabeth Woodcock, FACMPE
Medicare Fee Schedule Cut Again
DOWN, NOT OUT. Medical practices all over the country have been calling and e-mailing, anxious to know when the 2003 Medicare Physician Fee Schedule would be out. Usually released mid-November, the schedule for 2003 was not published until December 31, 2002, thanks to Congressional debates and delays.
It was not worth the wait. The "conversion factor" for 2003 -- a basic way to tell which direction reimbursement is moving -- dropped 4.4 percent from 2002's already low payments. Carriers will start paying on this schedule on March 1, 2003. The 2002 Fee Schedule remains in effect until then.
What does this mean for you?
Expect to make less -- or lose more -- on Medicare patients. For example, reimbursement for a 99204 office visit will drop to an average $124.19 from 2002's $139.68. A mammogram of both breasts, CPT code 76091, will drop 3 percent from $90.50 to $88.21. Brace yourself, too, for lower reimbursement from commercial payers, who figure that if you'll take low fees from the government, you'll take them from private sources, too.
But before you panic, it's important to find out exactly how your particular practice will be affected and plan adjustments accordingly. Knowledge is your best defense.
Get a copy of the 2003 Medicare Physician Fee Schedule to find out what you can expect to get paid this year for your most common procedures. You can download a copy of the Fee Schedule from www.cms.gov/REGULATIONS/PFS/.
You should download addendum B. Or, for an easier-to-read and easier-to-get version of the Fee Schedule, visit the Tools area of www.PhysiciansPractice.com. The Fee Schedule also includes global periods for every CPT code and values for new codes for 2003.
* Analyze the impact of the new, lower rates on your practice. Depending on what services you offer most often, your practice may be affected differently than others. It's important to know exactly what you are up against. To measure this, use the Fee Schedule to figure out what you'll be paid by Medicare for your top 10 services. One very easy way to do this is to use the 2003 Medicare Reimbursement Calculator in the Tools area of www.PhysiciansPractice.com.
* Prepare accordingly. Once you understand what your practice will face starting in March, you can plan a counterattack. Sadly, some physicians are considering dropping out of Medicare or at least closing to new Medicare patients. Others are looking for ways to cut overhead to keep afloat during this difficult year. For example, one practice I know is asking employees to pay for more of their own health insurance. Another has decided to stop taking call at one of its local hospitals, a decision that lowered its malpractice insurance rates. Perhaps there are new ways you can raise revenue or cut costs to offset Medicare's cuts.
Keep in mind that the impact of the 2003 Fee Schedule will, hopefully, be short-lived. Congress seems to agree that the formula used to compute physician reimbursement for Medicare has to change -- for the better. The devil is in the details, but physicians can hope realistically for better times in 2004.
To sign up to receive free Practice Management Pearls from Physicians Practice Inc., please visit: http://www.physicianspractice.com/index.cfm?method=parent&submethod=newsletter&&r=
If you would like to learn more about ePocrates DocAlerts, please visit
http://www.epocrates.com/products/docalert.cfm.
Best wishes,
The ePocrates Team
Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC Irvine
MD/MBA candidate
pottsbri@yahoo.com
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<FONT size=2>
<P>-----Original Message-----</P>
<P>From: AAEM [</FONT><A href="mailto:info@aaem.org"><U><FONT color=#0000ff size=2>mailto:info@aaem.org</U></FONT></A><FONT size=2>] </P>
<P>Sent: Wednesday, January 29, 2003 8:28 AM</P>
<P>Subject: Medicare Provider Payments</P>
<P>To AAEM members,</P>
<P>Good news from Washington. </P>
<P>AAEM Washington Update:</P>
<P>The Senate late Thursday (1/23) agreed to an amendment to use $900 million in the FY 2003 omnibus spending bill to prevent a 4.4% cut in Medicare payments to physicians. If the House agrees to this action during the Conference to be held to iron out the differences between the Senate and House bills, the physician payment reduction scheduled to take effect March 1 will not occur.</P>
<P>AAEM 611 East Wells Street Milwaukee, WI 53202</P>
<P>800-884-2236 Fax: 414-276-3349</P>
<P>E-mail: <A href="mailto:info@aaem.org">info@aaem.org</A> website: </FONT><A href="http://www.aaem.org"><U><FONT color=#0000ff size=2>www.aaem.org</U></FONT></A></P>
<P>================================================</P><FONT size=2>
<P>Senate passes bill to stop Medicare fee cut</P>
<P>Measure effective until Sept. 1, gives Congress time to make permanent changes </P>
<P>By Leigh Page <</FONT><A href="mailto:lpage@crain.com"><U><FONT color=#0000ff size=2>mailto:lpage@crain.com</U></FONT></A><FONT size=2>></FONT></P>
<P><FONT size=2>Jan 24, 2003 </P>
<P></P>
<P>After months of frenzied physician lobbying and false starts, the U.S. Senate on Thursday night finally passed legislation to cancel a planned 4.4% reduction in Medicare physician fees for the next six months. </P>
<P>The measure, part of Congress' $390 billion appropriations bill and effective until Sept. 1, is now almost certain to pass, allowing Congress time to make permanent changes, say lobbyists for physicians' organizations in Washington, D.C.. </P>
<P>"This is fee freeze, not a fee fix," says Priscilla Perry, M.D., chair of the government relations committee of the American Society of Cataract and Refractive Surgery, part of a coalition of specialty societies that has lobbied against the fee cuts. </P>
<P>"We very much appreciate the Senate being willing to take these steps, which will give some time to work on what we feel is the underlying problem: a deeply flawed payment formula," Perry adds. </P>
<P>The Senate passed the appropriations bill with the fee freeze in it at around 9 p.m. EST Friday, according to Nancey McCann, director of government relations, American Society of Cataract and Refractive Surgery. </P>
<P>McCann says the bill, which already passed the House without a fee freeze in it, now goes to a House-Senate conference committee next week after the House convenes next Tuesday. </P>
<P>Bush is expected to include longer-term changes for physician fees in his budget, which will be released in February, she says. </P>
<P>While the House last year passed a bill to avert the 2003 fee cuts, the Senate failed to follow up. Cherie McNett, director of government affairs for the American Urological Association, attributes the Senate's change of heart to the new Senate majority leader, Sen. Bill Frist (R-Tenn.). </P>
<P>"It's not because he is a physician; it's because he is a legislator," McNett says. "Under his leadership, I think you'll find that the Senate will move ahead with a variety of bills this year." </P>
<P>=====<FONT size=2></P>
<P>Promising comments from Tom Scully...</P>
<P></P>
<P>Antoine Kazzi</P>
<P></P>
<P>-----Original Message-----</P>
<P>From: California Healthline [</FONT><A href="mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM"><U><FONT color=#0000ff size=2>mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM</U></FONT></A><FONT size=2>] </P>
<P>Sent: Thursday, January 23, 2003 10:02 AM</P>
<P></P>
<P>CMS Administrator Scully Says Bush Administration Opposes Medicare Physician Fee Cuts </P>
<P>01/23/2003 </P>
<P></P>
<P></P>
<P></P>
<P>CMS <</FONT><A href="http://www.cms.gov/"><U><FONT color=#0000ff size=2>http://www.cms.gov/</U></FONT></A><FONT size=2>> Administrator Tom Scully yesterday said the Bush administration opposes scheduled reductions in Medicare reimbursements to physicians, "all but ensur[ing]" that the 4.4% drop in physician payment levels scheduled for March 1 will not go into effect, the <</FONT><A href="http://www.latimes.com/news/nationworld/nation/la-na-medicare23jan23,0"><U><FONT color=#0000ff size=2>http://www.latimes.com/news/nationworld/nation/la-na-medicare23jan23,0</U></FONT></A><FONT size=2>,</P>
<P>1891606.story?coll=la%2Dheadlines%2Dnation> Los Angeles Times reports. Speaking at a health policy conference in Los Angeles yesterday, Scully said, "The physician thing is an emergency, and it needs to be fixed now" (Kemper, Los Angeles Times, 1/23). Earlier this month, House Ways and Means Committee Chair Bill Thomas (R-Calif.) sponsored a bill that would use the Congressional Review Act, which allows Congress to overturn regulations recently published by a federal agency, to cancel the scheduled reduction. Scully said that a bill to overturn the regulation in order to prevent the scheduled cuts also would block "other things in the rule that are essential to running the [Medicare] program" ( <</FONT><A href="http://www.californiahealthline.org/members/basecontent.asp?contentid=4"><U><FONT color=#0000ff size=2>http://www.californiahealthline.org/members/basecontent.asp?contentid=4</U></FONT></A></P><FONT size=2>
<P>7659&collectionid=3&program=1%20> California Healthline, 1/10). Meanwhile, Sen. Charles Grassley (R-Iowa) has added a Medicare payment adjustment to the omnibus 2003 appropriations package that would freeze physician payments at 2002 levels and increase reimbursements to rural and small urban hospitals, the Times reports. However, Scully said in his remarks yesterday that the administration is only seeking to address physician payment levels, not reimbursements to other Medicare providers, adding, "The doctors' thing is a big mistake. All the other stuff can wait." </P>
<P></P>
<P></P>
<P>Medical Community Response </P>
<P></P>
<P>Last year, Bush's health care advisers said the president would not support higher reimbursement rates for providers without also implementing a prescription drug benefit for Medicare, but that position has "evolved significantly," according to the Times. A 5.4% reduction in Medicare reimbursement rates to physicians in 2002, combined with Congressional "deadlock" on a Medicare prescription drug plan, has prompted doctors to stop accepting Medicare patients "in droves," and many seniors are now "scrounging for care," the Times reports. The American Medical <</FONT><A href="http://www.ama-assn.org/"><U><FONT color=#0000ff size=2>http://www.ama-assn.org/</U></FONT></A><FONT size=2>> Association and other groups have lobbied "relentlessly" against the cuts, saying that the reductions would cause private insurers -- most of which tie their payment rates to federal levels -- to lower reimbursements, according to the Times. "It's all about access and keeping doctors afloa!
t," Dr. John Armstrong, member of the AMA board of trustees, said, adding that he was "very pleased" with Scully's comments. Scully also indicated that President Bush in his State of the Union address next week will highlight a Medicare prescription drug benefit and tax credits for the uninsured as critical domestic issues, according to the Times (Los Angeles Times, 1/23). </P>
<P></P>
<P></P>
<P></FONT>==========================================</P><FONT size=2>
<P>This is interesting. Look at your top 10 codes and see what your hit will be, factoring in your percentage of Medicare, which is a number you need to make the calculation of your loss due the Medicare new reduction for providers.</P>
<P>Elizabeth Woodcock is a well known expert in Medical Practice Management. Her perspective - on where Medicare is headed - is worth reading.</P>
<P>A. Antoine Kazzi, MD, FAAEM, FACEP</P>
<P>Vice President, the American Academy of Emergency Medicine</P>
<P>-----Original Message-----</P>
<P>From: docalerts@epocrates.com [</FONT><A href="mailto:docalerts@epocrates.com"><U><FONT color=#0000ff size=2>mailto:docalerts@epocrates.com</U></FONT></A><FONT size=2>] </P>
<P>Sent: Thursday, January 16, 2003 6:54 PM</P>
<P>Subject: Requested DocAlert information about Medicare Fee Schedule</P>
<P>Dear ePocrates Subscriber,</P>
<P>Here is the information you requested from the ePocrates DocAlert system: </P>
<P>PRACTICE MANAGEMENT PEARLS (SM)</P>
<P>A Weekly Report on Practice Management Issues</P>
<P>By Elizabeth Woodcock, FACMPE</P>
<P>Medicare Fee Schedule Cut Again</P>
<P>DOWN, NOT OUT. Medical practices all over the country have been calling and e-mailing, anxious to know when the 2003 Medicare Physician Fee Schedule would be out. Usually released mid-November, the schedule for 2003 was not published until December 31, 2002, thanks to Congressional debates and delays.</P>
<P>It was not worth the wait. The "conversion factor" for 2003 -- a basic way to tell which direction reimbursement is moving -- dropped 4.4 percent from 2002's already low payments. Carriers will start paying on this schedule on March 1, 2003. The 2002 Fee Schedule remains in effect until then.</P>
<P>What does this mean for you?</P>
<P>Expect to make less -- or lose more -- on Medicare patients. For example, reimbursement for a 99204 office visit will drop to an average $124.19 from 2002's $139.68. A mammogram of both breasts, CPT code 76091, will drop 3 percent from $90.50 to $88.21. Brace yourself, too, for lower reimbursement from commercial payers, who figure that if you'll take low fees from the government, you'll take them from private sources, too.</P>
<P>But before you panic, it's important to find out exactly how your particular practice will be affected and plan adjustments accordingly. Knowledge is your best defense.</P>
<P>Get a copy of the 2003 Medicare Physician Fee Schedule to find out what you can expect to get paid this year for your most common procedures. You can download a copy of the Fee Schedule from </FONT><A href="http://us.f415.mail.yahoo.com/ym/www.cms.gov/REGULATIONS/PFS/"><U><FONT color=#0000ff size=2>www.cms.gov/REGULATIONS/PFS/</U></FONT></A><FONT size=2>.</P>
<P>You should download addendum B. Or, for an easier-to-read and easier-to-get version of the Fee Schedule, visit the Tools area of </FONT><A href="http://us.f415.mail.yahoo.com/ym/www.PhysiciansPractice.com"><U><FONT color=#0000ff size=2>www.PhysiciansPractice.com</U></FONT></A><FONT size=2>. The Fee Schedule also includes global periods for every CPT code and values for new codes for 2003.</P>
<P>* Analyze the impact of the new, lower rates on your practice. Depending on what services you offer most often, your practice may be affected differently than others. It's important to know exactly what you are up against. To measure this, use the Fee Schedule to figure out what you'll be paid by Medicare for your top 10 services. One very easy way to do this is to use the 2003 Medicare Reimbursement Calculator in the Tools area of </FONT><A href="http://us.f415.mail.yahoo.com/ym/www.PhysiciansPractice.com"><U><FONT color=#0000ff size=2>www.PhysiciansPractice.com</U></FONT></A><FONT size=2>.</P>
<P>* Prepare accordingly. Once you understand what your practice will face starting in March, you can plan a counterattack. Sadly, some physicians are considering dropping out of Medicare or at least closing to new Medicare patients. Others are looking for ways to cut overhead to keep afloat during this difficult year. For example, one practice I know is asking employees to pay for more of their own health insurance. Another has decided to stop taking call at one of its local hospitals, a decision that lowered its malpractice insurance rates. Perhaps there are new ways you can raise revenue or cut costs to offset Medicare's cuts.</P>
<P>Keep in mind that the impact of the 2003 Fee Schedule will, hopefully, be short-lived. Congress seems to agree that the formula used to compute physician reimbursement for Medicare has to change -- for the better. The devil is in the details, but physicians can hope realistically for better times in 2004.</P>
<P>To sign up to receive free Practice Management Pearls from Physicians Practice Inc., please visit: </FONT><A href="http://www.physicianspractice.com/index.cfm?method=parent&submethod=news"><U><FONT color=#0000ff size=2><A href="http://www.physicianspractice.com/index.cfm?method=parent&submethod=newsletter&&r=If">http://www.physicianspractice.com/index.cfm?method=parent&submethod=news</U></FONT></A><FONT size=2>letter&&r=</P>
<P>If</A> you would like to learn more about ePocrates DocAlerts, please visit </P>
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<P>Best</A> wishes, </P>
<P>The ePocrates Team</FONT></P></FONT><BR><BR><STRONG>Brian Potts <BR>Managing Editor, CAL/AAEM News Service</STRONG> <BR>MS-IV, UC Irvine <BR>MD/MBA candidate <BR>pottsbri@yahoo.com<p><br><hr size=1>Do you Yahoo!?<br>
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