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Doctors May Limit Patients After Change in Medicare
By Vic Kolenc, El Paso Times
April 1, 2008
Urologist Dr. David Taber examined patient Larry Quisenberry on Monday in his offices at 2201 N. Stanton. Taber said a pending 10.5 percent cut in Medicare reimbursements might keep him from accepting new Medicare patients.
Doctors in El Paso and throughout the country are up in arms over a pending 10.5 percent cut in Medicare payments to doctors.
The pending cut is the result of a years-old federal formula for paying doctors for treating Medicare patients. Doctors groups said the formula needs to be fixed because it doesn't keep up with their growing expenses and forces them to see fewer Medicare patients.
Several hundred doctors are expected to take part in a rally in Washington, D.C., Wednesday to urge Congress to take action to stop the cut and reform the Medicare payment system. Past Medicare payment cuts have been stopped by Congress, but it has failed to reform the system, doctors said.
"Doctors are not greedy. We just want to be able to keep up with office expenses and so on," said Dr. David Taber, an El Paso urologist and president of the El Paso County Medical Society. "Medicare reimbursements have essentially been frozen since 1993 despite our expenses going up.
"If the planned cut goes into effect, I'd say over 95 percent of (El Paso) doctors will stop seeing new Medicare patients" based on a local survey of doctors, Taber said. "I won't accept any new Medicare patients" if the cut occurs, he said.
Frank Armendariz, 70, president of an East Side chapter of the American Association of Retired Persons, blamed lower Medicare payments for reducing access to his doctor.
"They (Medicare) don't pay like they used to, so they (doctors) don't want to see us as much," Armendariz said. "I think doctors deserve better reimbursements. If not, they may cut us out completely."
A Texas Medical Association survey found about a third of 749 Texas doctors responding to a survey last month are accepting fewer new Medicare patients. Forty-six percent said if the July cut goes into effect, they will consider taking no new Medicare patients.
"Two years ago, 68 percent (of Texas doctors surveyed) were seeing new Medicare patients. Now, that's at 58 percent. So we're seeing a trend," Dr. William Hinchey, a San Antonio pathologist and president of the Texas Medical Association, or TMA, said from Washington, D.C., Monday.
Nationally, 60 percent of doctors surveyed by the American Medical Association said the July cut would force them to limit the number of new Medicare patients they treat, the association reported.
"Let's not have draconian cuts affect access," Hinchey said. "We need to reform the (payment) methodology."
The TMA is backing two bills now in the U.S. Senate. One was recently introduced by U.S. Sen. John Cornyn, R-Texas. It would institute some short-term and long-term changes. Another bill authored by U.S. Sen. Debbie Stabenow, D-Mich., would bring some short-term help to doctors.
Amanda Fredriksen, advocacy manager for the Austin office of the American Association of Retired Persons, or AARP, said, "It's frustrating to our members because they are losing access to doctors and their (Medicare) premiums are rising. Medicare premiums have doubled since 2000."
AARP last year urged Congress to take "excess payments" made to Medicare Advantage, a private insurance plan paid with Medicare dollars, and use that money to "pay physicians an appropriate payment and provide relief on (patient) premiums," Fredriksen said.
The Texas Medical Association said health insurance companies that provide Medicare Advantage "reap double-digit, multimillion-dollar profits." Many doctors do not accept patients with Medicare Advantage, it reported.
Taber, the El Paso doctor, said the government is throwing away several billion dollars a year on Medicare Advantage payments to insurance companies.
The TMA said while doctors' payments decline, Medicare payments to Medicare Advantage plans, hospitals and nursing homes continue to go up because their payments are based on a different formula.
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