CMS Prepares to Hold Physician Reimbursements for Fifth Time This Year!

CMS Prepares to Hold Physician Reimbursements for Fifth Time This Year!

In yet another sign of the gross mismanagement taking place under the Democratically run Congress, sources inside Washington are saying that the Center for Medicare and Medicaid Services (CMS) is preparing to hold physician reimbursements for the fifth time this year.  Although the decision has not been made public at this time, the expectation is that it will be announced soon.

The move comes as Congress prepares to go on its Memorial Day break without addressing the issue of correcting the Sustainable Growth Rate formula (SGR) fix on Medicare reimbursements to physicians.  In the meantime, the mistrust towards government run health care and frustration over the ineptitude displayed by a Congress that had promised America’s doctors a permanent resolution to the ills of physician reimbursement in exchange for support for its health care reform agenda continues to grow.  In Texas, the number of physicians who have opted out of Medicare has grown ten-fold, while in Medicare-heavy Florida, physicians are figuring out ways of either opting out of Medicare or closing their practices altogether. 

“The situation is deplorable,” one area cardiologist told me.  “I can’t tell you the emotional toll this has taken on me.”  

The situation is just the latest manifestation of the ineptitude the Democrats have displayed in handling health care reform.  The issue of implementing a permanent fix to Medicare reimbursements was integral to the original plans of the health care legislation prompting the American Medical Association to offer its support for the bill, but Democrat leaders removed the “doctor-fix” provision from the bill when they realized that the $250 billion dollars it would take to permanently address the physician reimbursement issue would cause the Congressional Budget Office’s score of the bill to climb over $1 trillion. 

In their infinite wisdom, the Democrats thought it fit to address their mammoth overhaul of the health care system without addressing the central pillar of health care, the men and women who deliver the care.  As a result, physicians now find themselves in the midst of yet another financial blow to their practices.  

“What this means to me,” said one physician in Venice, Florida, the highest Medicare percentage area in the country, “is first, that the AMA in was once again flagrantly incompetent in representing us this year, and second, that we need to stop participating in the Medicare system.”  

“It is obvious that the government cannot pay for the care of our seniors and doesn’t really care to.  The solution is that they need to stop trying and admit that they can’t and let us negotiate our fees with our patients.  Patients and doctors alike would be much better off if the government just had the courage to admit its shortcomings,” said a Venice orthopaedist.  

Unconfirmed reports detail that the so-called doctor fix intended to patch the problem for a period of four years dwindled over the pasts two weeks to a 16 month fix, and now hovers at another 30 day moratorium to be voted on as part of the jobs benefits program upon the Congress’s return to work in early June.  In the meantime, Medicare claims for services taking place after May 31 will not be processed.  

“We’ll see what happens,” one general surgeon said.  “Come Tuesday, I’ll see where we are and consider whether I can continue seeing Medicare patients.”  

Julio Gonzalez, M.D.
Venice, Florida
Chair Legislative Committee of the Florida Orthopaedic Society
Councilor to the American Academy of Orthopaedic Surgeon’s Board of Councilors
Author, Health Care Reform: The Truth

Tom Tillison

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