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TMA opposes a Centers for Medicare & Medicaid Services (CMS) plan to give Medicare Advantage plans a 3.6-percent fee increase at the same time it plans to cut payments to physicians.
"Instead, we ask that you use that money to make sure our senior citizens and Texans with disabilities can find a physician when they need one," TMA President William W. Hinchey, MD, wrote in a letter [PDF ] to U.S. Sens. John Cornyn and Kay Bailey Hutchison and Texans in the U.S. House of Representatives.
TMA has no quarrel with Medicare Advantage plans but "we simply have a hard time understanding why CMS is proposing payment increases for Medicare Advantage plans when they already are being paid at 15 to 50 percent above the market rate. To boot, physician payments basically have been stagnant for the past seven years; if not for the proactive work of Congress, physician payments would have been reduced by more than 30 percent."
Dr. Hinchey said it is "blatantly unfair" to "unduly enrich the health plans simply for brokering or repackaging existing medical services. Whether that care is provided through the Medicare Advantage plan or through traditional Medicare, the actual payment rates to physicians should be the same."
Physician practices have to make difficult business choices because of inadequate Medicare payments to physicians, he added. "We are forced to place limits on new Medicare patients, and we reduce the amount of charity care we can provide. Even so, more than 70 percent of Texas physicians tell us they will not displace their current Medicare patients."
Dr. Hinchey said Congress "should not allow CMS to authorize any payment updates until a rational physician payment system is designed that reflects the actual costs for physicians of providing medically necessary health services to our patients. If this means that existing Medicare funding sources must be reallocated from existing providers and payers, particularly those receiving 'automatic' updates, so be it. This is the fairest way to ensure that all Medicare patients can continue to obtain care from their local providers, and in particular, from their personal physicians."
Medicare payments to physicians will be cut by 10.5 percent on July 1 unless Congress intervenes. Dr. Hinchey led a delegation of 12 Texas physicians, 10 TMA Alliance members, five medical students, and six TMA staff members to Washington, D.C., earlier this month to lobby for a new Medicare physician payment system. They also discussed problems with health insurance companies' inadequate payments for vaccines and the need to preserve physicians' rights to own hospitals and other health care facilities.
Read the Texas Medicare Manifesto to find out how TMA is working to solve the Medicare crisis.
Action, April 15, 2008
Last Published: 4/14/2008 Print this page
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