DOCTORS TRY TO THWART CUTS TO MEDICARE — As the countdown to year’s end continues, health care providers are racing to avert a tsunami of potential Medicare reimbursement cuts that kick in unless Congress acts.
As lawmakers put together the year-end package, these are the most talked about cuts on Capitol Hill:
— Physician Fee Schedule cuts: Doctors face a 4.5 percent across-the-board cut to Medicare reimbursement rates next year. Some specialties are at risk for additional reimbursement cuts as well.
— PAYGO-mandated cuts: All providers face a 4 percent reduction in payments if Congress doesn’t waive the cuts triggered by the pay-as-you-go budget control requirements.
— Alternative Payment Model bonuses sunset: A 5 percent bonus for providers who participate in so-called Advanced Alternative Payment models, which require doctors to take on some risk related to health outcomes for patients, expires at the end of the year.
— Clinical laboratory cuts: Medicare payments for clinical laboratory tests could face a 15 percent cut.
Providers have been holding meetings with congressional offices for months to try to avert the future cuts, but that lobbying is now being pushed into overdrive, Megan reports.
And if you are using Medicare, this may affect you…
Healthcare Leadership Council
- The Centers for Medicare and Medicaid Services says the number of doctors who’ll take Medicare patients is falling.
- A combination of constant battles over reimbursement rates, red tape and payment below what services actually cost has simmered for a long time.
- Medicare now faces the same tell-tale signs of trouble as Medicaid, the low-income health program. One-third of primary care doctors won’t take new patients on Medicaid.
- While the number of Medicare decliners remains relatively small, the trend is growing. If it continues, that could make it more difficult for seniors to get timely treatment.
Medicare reimbursement rates should not be cut and the various healthcare lobbyists can probably hold the cuts at bay. Medicare is one step above Medicaid as far as reimbursement goes and that is one step above the providers giving out free care.
How to get out of this mess is above my pay grade.
Every citizen in one big pool paying what is a reasonable cost for the access to and quality of healthcare care Americans are will to pay for.
I don’t know about Medicare, but I do know that after I had made my selection for medical insurance coverage for 2023, I was informed by my orthopedic office that they are dropping two insurance companies starting in February 2023 and that they will glad charge out of network rates if you still want to see them. I kind a of wish that they made that announcement back in September so that I at least I could investigate to see if my company offered any different options before I selected my plan. I don’t think they do. I guess I’ll be looking for a new specialist.
I wonder how many Medicare patients are going to find out the hard that their doctor no longer accepts Medicare.