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Tell your Legislators to Fix the Broken Medicare Reimbursement System

Medicare Payment Reform

The Chicago Tribune (7/19) editorialized, “If your boss threatened to slash your pay by 21 percent, then said ‘never mind,’ then threatened again, then changed his mind, then threatened again, and kept this up for eight years,” you would be ready to quit. “That’s how Congress has been dealing with doctors who treat Medicare patients. And lo and behold, a lot of doctors are walking away from Medicare.”

Americans need a rational Medicare physician payment system that automatically keeps up with the cost of running a practice and is backed by a fair, stable funding formula. Sign the online “Stop the Medicare Meltdown” petition today. Download a paper petition (ColorBlack/White) to help gather signatures.

Physicians: Download a “Stop the Medicare Meltdown” poster for your office: ColorBlack/White

Medicare Payment News: On June 25 President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.” This law provides a 2.2% update to the Medicare physician payment rates retroactive from June 1 through November 30, 2010. CMS has directed a stop on claims processing at the negative update rates (the 21% cut enacted June 1) and a temporary hold on claims for services of June 1 and later, until the new 2.2% update rates are tested and loaded into the claims processing systems. CMS expects to begin processing claims at the new rates by July 1. Claims for services rendered prior to June 1 will continue to be processed and paid as usual. For more information, including what to do for claims recently submitted, visit HMA’s Medicare Updates page.

A Permanent Fix Needed: Physician and patient advocates are calling for a permanent fix to the sustainable growth rate (SGR) formula, which has been the cause of steep payment cuts. Past short-term patches have only made the problem worse. Congress needs to solve the problem permanently, to preserve access to care and provide physician practices with the financial stability they need to care for our seniors.

Problem Affects All Healthcare: The Medicare payment formula also directly affects reimbursement rates from TriCare (coverage for military families) and Medicaid. Additionally, most commercial insurance payment schedules are based on a percentage of Medicare rates.

Call (800) 833-6354, the AMA Grassroots Hotline, to be directly connected with your legislators.

Tell your legislators:

  • Congress must fulfill its obligations to Medicare patients and military families covered by TRICARE.
  • Short-term patches that only make future cuts deeper and the cost of a permanent solution more expensive are not the answer.
  • Cuts in Medicare payments, which already do not cover the cost of providing care, will adversely affect Medicaid reimbursements, and even those from private insurers, who often base payments on Medicare rates.
  • The fiscally responsible solution is permanent repeal of the SGR formula.

Send an e-mail directly to your representative through the AMA Grassroots Action Center at www.ama-assn.org/go/grassroots.

Letter to US Senate from AMA President

Medicare Payment Materials:

  • Flyer for physicians
  • Medicare Payment Action Kit
  • Flyer for patients

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