Jillo, haven't you read AAP/PLAN - Psychology's Political Action Assn.?
December 13, 2010
Dear AAP Supporter,
We are very happy to report that a bill to freeze Medicare reimbursement for psychologists and physicians through the end of 2011 cleared Congress on December 9, 2010 and goes to President Obama for his signature. As a result of this action, the January 1, 2011 scheduled 25% cut in reimbursement has been averted for a full year. The measure also includes a one-year extension of the 5% psychotherapy payment restoration. This will ensure the continuation of $30 million in Medicare reimbursements for 2011. The bill also provides financial resources to the Centers for Medicare and Medicaid Services (CMS) to process backlogged payments for claims since January 1, 2010 to which the restoration will be retroactively applied.
This Congressional "doc fix" was spurred by intense lobbying efforts from a broad array of health care provider groups including the APA Practice Organization working together hand in glove with the political advocacy efforts of AAP. Congress does seem to understand that a massive reduction in Medicare reimbursement would cause a large number of providers to stop seeing Medicare patients. Military families also would have found their access to physicians jeopardized because their TRICARE coverage is based on the Medicare fee schedule.
In addition to freezing physician compensation at current Medicare levels, the legislation extends expiring Medicare payment policies and funds minor changes to Medicare, Medicaid, and the Children's Health Insurance Program. Of note, Congress has delayed the Medicare pay cut on 5 separate occasions this year amid much wrangling on how to finance it.
The proposed pay cut that has tormented Medicare providers and Congress alike is triggered by the sustainable growth (SGR) formula that Medicare uses to set doctors' reimbursement. The formula pegs reimbursement to growth in the gross domestic product. Provider groups contend that the formula is flawed because practice costs exceed gross domestic product inflation. The formula has mandated Medicare rate reductions every year going back to 2003, but Congress has postponed each one. Because the reductions accumulate over time, providers found themselves looking at a virtually bottomless reimbursement chasm on January 1.
We are all hopeful that the 1-year freeze will give us enough time to hammer out a permanent solution to the Medicare reimbursement crisis that health providers find more equitable and Congress finds affordable. The recent recommendations of a bipartisan commission created by President Obama to reduce the federal budget deficit may offer guidance. A report drafted by the commission's co-chairmen proposed freezing Medicare rates through 2013, reducing them by 1% in 2014, and then instituting a new pay formula in 2015 that rewards providers for the quality - not quantity - of their services.
Sincerely,
Stephen M. Pfeiffer, Ph.D. Nanci C.Klein,Ph.D.
Executive Director Chair
AAP Board of Trustees
Ronald E. Fox, PhD, PsyD
Douglas Haldeman, PhD
Nanci C. Klein, PhD - Chair
Michael Murphy, PhD
Gilbert Newman, PhD
Judith Steller, PhD - Secretary
Executive Director
Stephen M. Pfeiffer, PhD
Honorary Board
DorothyCantor, PsyD
Raymond Fowler, PhD
Alan Kazdin, PhD
Martin Seligman, PhD
Philip Zimbardo, PhD
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That's good news that Medicare cuts averted, Jillo!!!
It is a perfect example of the way that insurance carriers contribute to rising health care costs.
