PARK RIDGE, Ill., Nov. 19 /PRNewswire/ -- Concerned that some seniors will
not have access to their doctors in the near future, James E. Cottrell, M.D.,
president of the 38,000-member American Society of Anesthesiologists, called
on Congress to enact legislation before adjourning that would pave the way for
correcting errors in the Medicare update formula for physicians' fees.
"Without congressional action before year-end," Dr. Cottrell said,
"Medicare's formula will cut reimbursement to physicians participating in the
Medicare program by another 4.4 percent on January 1, on top of the 5.4-
percent cut applied last January 1.
"The cost to practice medicine is on the rise by as much as 2-3 percent
annually," Dr. Cottrell said. "These further cuts in reimbursement virtually
guarantee an access crisis for Medicare beneficiaries in 2003. Congress
simply must find a way to act."
Like other small businesses, doctors cannot continue to provide services
at a deficit, he said. The American Medical Association (AMA) recently
reported that more than 20 percent of physicians this year were no longer able
to accept new Medicare patients. AMA projects that twice that many may be
forced to follow suit.
Further compounding the frustration of the situation is the fact that the
decrease is, in large part, due to Congress' enactment of a flawed update
formula tied to the Gross Domestic Product and to unintended administrative
errors in calculating the formula update in 1998 and 1999, Dr. Cottrell said.
Last June, the House of Representatives passed legislation that would have
produced positive updates in the years 2003-2005, but the Senate took no
action. More recently, in a different approach to the problem, the House
passed H.R. 5063, which contained a provision insulating the Bush
Administration from suit if it acted to correct past errors in administering
the update formula and thereby assuring a positive update for 2003. Again,
the Senate has this past week balked at dealing with the problem.
"Neither my colleagues in medicine nor I can understand the Senate's
reluctance to act," Dr. Cottrell said. "Reportedly some Senators don't want
to deal with the physician schedule problem without dealing with the needs of
other provider groups. Last year, a supermajority of Senators co-signed a
bill that would have dealt with the fee schedule problem alone, so why is the
situation different now?"
Dr. Cottrell noted that there is a major distinction between the
physicians' situation under Medicare and that of other providers: "Here we
are talking about real cuts in reimbursement brought about by a flawed formula
and unintended administrative errors," he said. "In the case of other
providers, the issue is about lessening a cut intentionally legislated by
Congress a few years ago."
The situation is critical for many physicians and specialists, but Dr.
Cottrell noted that anesthesiologists are among those who have taken a
particularly hard hit.
"Anesthesiologists are paid less by Medicare today than they were in 1991
when the fee schedule was enacted," Dr. Cottrell noted. "What hospital or
nursing home is able to say the same? None, not one."
In fact, Medicare and Medicaid anesthesia fees are so low that one-third
of hospitals are temporarily subsidizing their anesthesiology departments to
keep them running, Dr. Cottrell said. "In essence, Part A funds are being
used to prop up Part B, essentially because Congress is unwilling, for
whatever reason, to adequately fund the reasonable cost of physician
services," he said.
The Centers for Medicare & Medicaid Services has deferred soliciting
advice from the nation's physicians as to whether they will participate in the
Medicare program next year, pending possible action by Congress.
"We simply cannot permit this Medicare meltdown to occur," Dr. Cottrell
said. "The Senate has it within its power to take the first step toward
reimbursement sanity by restoring to the nation's physicians the funds the
government has taken from them through admitted miscalculations.
"For the sake of Medicare patients everywhere, the Senate must act on this
issue before it goes home."
Founded in 1905, the American Society of Anesthesiologists is a scientific
and educational association of anesthesiologists that was organized to advance
the practice of anesthesiology and to improve the quality of care of the
anesthetized patient. It is the largest organization of anesthesiologists in
the world with more than 38,000 members.
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SOURCE American Society of Anesthesiologists