MEMBER ALERT:

We need for GCMGMA members to write our United States Senators from Texas to request their support of S. 1660, which will keep the 5.4% reduction in Medicare rates from being implemented and will substitute a 0.9% rate reduction.

Here are the addresses of our Senators:

Gramm, Phil
370 RUSSELL SENATE OFFICE BUILDING
WASHINGTON DC 20510
(202) 224-2934
phil_gramm@gramm.senate.gov

Hutchison, Kay Bailey
284 RUSSELL SENATE OFFICE BUILDING
WASHINGTON DC 20510
(202) 224-5922
senator@hutchison.senate.gov

As an example, two of our members have provided the text of the letter they have sent.  Feel free to borrow from these, or use the points at the end that were outlined on the MGMA Government Affairs web site:

Letter 1...

Dear Senator Hutchison:

We are a group of 5 neurosurgeons in Houston Texas Medical Center.  We are asking you to support Senator�s Breaux and Jeffords bill �Medicare Physician Payment Fairness Act of 2001�.

The current proposed decrease of 5.4 percent in Medicare reimbursement rates is unreasonable, especially in an environment where we have experienced skyrocketing professional liability insurance increases, and significant increases in staff salaries and other fixed expenses.  None of these expenses have decreased with the current recession. 

I am sure you already realize that the current Medicare rates do not cover our overhead and Medicare patients are becoming an increasingly larger percentage of the patients we treat.

Therefore, reductions in physician reimbursement rates places physicians like ourselves in a position where we may no longer be able to afford to treat Medicare patients.  This will significantly reduce Medicare patient�s access to quality care and is doing a disservice to our nation�s senior citizens and to the care providers.

Please consider these issues before allowing the proposed steep reduction in the Medicare physician fee schedule.  If we can be of assistance, please call us at 713-790-1211.

Thank you again for your support. 

Letter 2...

Dear Senator Gramm:

We understand that the formula used to calculate Medicare reimbursement for each successive calendar year is based on the economic growth of the nation.  According to the current formula and the economy, a 5.4% decrease is on the books for next calendar year.  We urge you to reconsider and support the Breaux/Jeffords bill cited above, as well as to consider putting forth your own legislation amending the calculation for the future.

When considering the impact of such a dramatic rate cut on physician practices, you need to realize the totality of the impact on the access of patients to care.  The formula in its current state does not accurately estimate the actual cost of running a medical practice such as ours.  Space, staffing and supply costs do not shrink over time, but increase at rates more closely tied to the rate of inflation.  Using that index for a future formula would be much more tolerable to those of us providing care to seniors.

Also, a dramatic reduction in Medicare rates would have a ripple effect on our practice and on others.  We have contracts that specify reimbursement as a multiplier of RBRVS rates.  Dropping Medicare rates by 5.4% will give our payors the opportunity to likewise modify their payments to us, increasing the impact of the Medicare decrease.

Finally, with the growing number of seniors who are retiring every day, as the baby boom generation becomes the Medicare generation, anything that negatively impacts the financing of medical care can only have a detrimental impact on the number of physicians who accept new Medicare patients.  Ultimately, this will significantly affect patients� access to care, at the very time of their life when their need for good medical care begins to increase.  Without access to primary care, patients will be sicker when they finally DO seek care, and the cost of that care will be at its very peak, unnecessarily burdening the system and the patient.

Mitigating the decrease from 5.4% to 0.9%, while not fully meeting our increased expenses for 2001, will go a long way towards keeping us afloat during these tenuous times.  We urge your support of the aforementioned bill.

Thank you for your consideration.

 Sincerely,

...and, finally, from the MGMA Government Affairs web site:

Points to make in your communication with your Senators are:

• The formula used to update Medicare payments does not accurately estimate the actual cost of running a practice. The latest MGMA cost survey data indicate that during 2000 the total operating cost for group practices rose by some 6.2 percent.

• Physician group practices have contracts with private payers linking their payment rates to the Medicare fee schedule. A drop in Medicare payments will mean a commensurate drop in reimbursement from numerous other sources, damaging their ability to provide care to both Medicare beneficiaries and privately insured patients.

• No other payment system under Medicare fluctuates with the GDP. Only physician fees are tied to this type of formula.

• Payments to Medicare + Choice plans are linked to Medicare fee-for-service spending, so cuts in physician payments would be disadvantageous to the plans, making it even more difficult to reverse the trend of plans withdrawing from the program. It also would be hard for Congress to defend increasing payments to plans if physicians were subject to payment cuts, particularly when Medicare + Choice plans already are guaranteed a 2% annual increase.

• Across-the-board cuts in Medicare physician payments will have immediate negative consequences for patient access to physician services. Already, surveys have shown that many physicians over the age of 50 plan to retire early and patients in some localities have trouble finding physicians who are willing to accept new Medicare patients. These problems will quickly worsen with an across-the-board reduction.

Dan Finch of the Harris County Medical Society sent these comments 11/16/01: