With its Sunbelt location, Los Angeles is home to many seniors. If a proposed “doc fix” becomes mandated, seniors in LA may have trouble finding a physician. On September 15, an austerity package was submitted to the Medicare Payment Advisory Commission (MedPac) as a solution to the program's reimbursement crisis; the fix would spread Medicare reimbursement cuts between both beneficiaries and providers. The proposed “doc fix”, which would ultimately require Congressional approval, would mandate a 10-year freeze of Medicare pay for primary care physicians. Specialists would experience a 5.9% pay cut for three full years, followed by seven years of no change. In addition to Congress and organized medicine, MedPac wants to avert a 29.5% reduction in Medicare rates on January 1, which is mandated by the program's sustainable growth rate formula for setting physician reimbursement. This massive reduction is assumed in federal budget projections; therefore, repealing the sustainable growth rate and freezing physician pay at 2011 levels would essentially put the government roughly $300 billion further into debt. By shrinking specialist reimbursement for three years, the MedPac plan lowers that cost to roughly $200 billion. The $235 billion in offsets would come from cuts to Medicare Part D drug plans (32%), post–acute care facilities (21%), hospitals (11%), laboratories (9%), suppliers of durable medical equipment (6%), Medicare Advantage plans (5%), and other providers (2%), with an additional 14% carved out of Medicare benefits to seniors. MedPac is scheduled to vote on the plan for physician reimbursement when it meets again in early October. If approved, the plan then would be considered by Congress.
Organized medicine has warned that a 29.5% drop in Medicare rates would cause scores of physicians to leave the program, making it harder for seniors to receive medical care. However, the preliminary MedPac proposal for staving off this doomsday scenario did not endear itself to medical societies such as the American Medical Association (AMA). "The misguided scheme discussed by MedPAC to replace the nearly 30% cut to physicians scheduled for January 1 with a new series of very significant cuts will harm patients and physicians in the Medicare program," AMA President Peter Carmel, MD, said in a statement. "The new cuts are inconsistent with MedPAC's previous recommendations to stop cuts to physicians who care for Medicare patients because they threaten access to care for patients and would have severe consequences for the Medicare system." He added that since 2001, Medicare reimbursement has failed to keep pace with the cost of running a medical practice.
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