CMS advocates for payment reform

Chicago Medical Society leaders were in Washington, DC, to advocate for reimbursement reform on behalf of CMS members.  Before departing for the Feb. 15-16 trip, they asked CMS physicians for their input and heard from many who are struggling to keep their practices afloat, as a result of inadequate and delayed Medicaid payments and the flawed Medicare SGR formula.

During their visit, Dr. Thomas M. Anderson, CMS President, and Dr. Howard Axe, President-elect, met with one-third of Illinois’ congressional delegation, and Senator Richard Durbin as well.  Concurrently, Congress was considering a permanent fix to the SGR by using the monies from the Overseas Contingency Operations (OCO) fund as an offset for the accumulated SGR bad debt.

Even though Senator Durbin supported this legislation, the vast majority of Congress members did not, much to the medical community’s frustration.

“Rather than implementing a lasting solution that guarantees fair payment to doctors who treat Medicare patients, Congress  kicked the can down the road—for the 14th time in the last 10 years!” Dr. Anderson said.

Medicare administrators tell Congress that despite their numerous complaints about Medicare, 96% of all practicing American physicians accept Medicare insurance and treat Medicare patients.  Since the care is still being delivered, Congress just doesn’t consider physician payment a compelling issue.

“Congressional staffers told us that doctors would be well advised to encourage their patients to go viral on the Internet, Facebook or Twitter, and elsewhere, because a larger group of concerned voters would have a greater impact on congressional behavior,” Dr. Anderson said.

The CMS leaders expressed members’ concerns directly to Sen. Richard Durbin; Reps. Mike Quigley; Danny Davis; and Jesse Jackson, Jr.; a senior staff member of House Speaker Rep. John Boehner, and a legislative aide to Rep. Mark Kirk.

While Dr. Anderson affirmed that Senator Durbin, along with Representatives Davis, Quigley, and Jackson, were supportive, “overall, we’re not happy,” he said.  He explained why:

“While Congress halted the 27% cut scheduled for March 1, and froze physician fees at current levels for the rest of the year, the issue will come up again after the elections and before the year ends.  If not addressed, the SGR will require a Medicare physician payment cut of 32% starting Jan. 1, 2013.  A permanent fix, if it ever happens, will be even more expensive then.”

Dr. Anderson asked of the legislators:  “Why place innocent lives in jeopardy before taking action?”

He reassured CMS members that back home, CMS will continue efforts in each congressional district to urge legislators to do the right thing--replace the flawed SGR formula.