If Congress doesn't block the Medicare physician fee cut, it would be a "catastrophe," setting off an exodus of physicians from the program and constricting beneficiaries' access to care, AMA President Cecil Wilson, MD, said in an interview with Kaiser Health News.
When Congress comes back into session on Nov. 15, it will have only 15 days to fend off an automatic 23 percent reduction in fees, which would start Dec. 1 and then increase by 6.5 percent on Jan. 1. CMS would be able to withhold the fee cut for 15 days, but when this was done earlier this year, many practices suffered very tight finances and some had to take out loans.
The AMA is simultaneously calling on Congress to pass a 13-month fee patch and advising physicians on how they could end full participation in Medicare if Congress does not take action.
The 13-month patch, lasting until January 2012, would cost $15 billion, and AMA is asking Congress during that time to find a way to abolish the automatic cut for good, at a price to the federal budget of $276 billion through 2020.
Dr. Wilson said 400 physicians across the country were involved in a recent AMA webinar discussing how they could change to Medicare non-participation status during an annual window lasting until Dec. 31. The AMA also has posted a "Medicare Participation Kit" discussing options on its website.
Physicians have three options:
1. Keep participating in Medicare. This means they accept Medicare’s allowed charge as payment in full.
2. Switch to non-participation. CMS pays non-participating physicians 5 percent less but they are permitted to balance-bill patients an amount that is 9.25 percent above what CMS pays participating physicians.
3. Opt out of Medicare entirely. Physician would not be paid anything by Medicare but could charge their full rates to Medicare beneficiaries. Physicians must give 30-days notice to do this.
Read the Kaiser Health News report on the physician fee cut.
Read the AMA advisory on switching Medicare status.
Read more coverage on Medicare reimbursements:
- GOP Victory Might Prompt Longer-Term Physician Fee Fix
- AMA Asks CMS to Postpone 2011 Medicare Fee Rule
- Physician Groups Hint of Exodus from Medicare if Congress Lets Fee Cut Start Again
When Congress comes back into session on Nov. 15, it will have only 15 days to fend off an automatic 23 percent reduction in fees, which would start Dec. 1 and then increase by 6.5 percent on Jan. 1. CMS would be able to withhold the fee cut for 15 days, but when this was done earlier this year, many practices suffered very tight finances and some had to take out loans.
The AMA is simultaneously calling on Congress to pass a 13-month fee patch and advising physicians on how they could end full participation in Medicare if Congress does not take action.
The 13-month patch, lasting until January 2012, would cost $15 billion, and AMA is asking Congress during that time to find a way to abolish the automatic cut for good, at a price to the federal budget of $276 billion through 2020.
Dr. Wilson said 400 physicians across the country were involved in a recent AMA webinar discussing how they could change to Medicare non-participation status during an annual window lasting until Dec. 31. The AMA also has posted a "Medicare Participation Kit" discussing options on its website.
Physicians have three options:
1. Keep participating in Medicare. This means they accept Medicare’s allowed charge as payment in full.
2. Switch to non-participation. CMS pays non-participating physicians 5 percent less but they are permitted to balance-bill patients an amount that is 9.25 percent above what CMS pays participating physicians.
3. Opt out of Medicare entirely. Physician would not be paid anything by Medicare but could charge their full rates to Medicare beneficiaries. Physicians must give 30-days notice to do this.
Read the Kaiser Health News report on the physician fee cut.
Read the AMA advisory on switching Medicare status.
Read more coverage on Medicare reimbursements:
- GOP Victory Might Prompt Longer-Term Physician Fee Fix
- AMA Asks CMS to Postpone 2011 Medicare Fee Rule
- Physician Groups Hint of Exodus from Medicare if Congress Lets Fee Cut Start Again