AMA launches ads pushing Senators on 'doc fix' while warning on cuts

The American Medical Association has launched a multi-million-dollar series of ads pressuring senators to intervene to prevent a scheduled payment cut for doctors who treat Medicare patients and warning that a separate permanent fix of the system is the only way to completely ensure continuity of care for seniors.

CongressDaily: "The payment cut took effect Tuesday, but the Centers for Medicare and Medicaid Services ordered a temporary freeze on doctor payments, anticipating that Congress would address the payment issue when it returns next week." AMA President Dr. James Rohack said in a conference call Thursday that the cut puts care at risk for seniors and military families. "The Medicare reimbursement formula is also used to determine TRICARE physician pay. AMA also released a survey of over 9,000 physicians, finding that nearly 60 percent of them considered opting out of Medicare in response to this year's two previous short-term delays to the 21 percent payment cut. The group also reported that one-third of primary care physicians restrict the number of Medicare patients they see, largely because doctors believe payment rates are too low and fear future cuts" (McCarthy, 6/3).

Reuters: "Before Congress left town, the House of Representative voted to postpone the pay cut. But the Medicare pay issue has gotten caught up in Senate wrangling over budget deficits and the cost of an economic package that would extend jobless benefits and tax breaks aimed at stimulating the economy. The doctors' group has been lobbying for a permanent change in the payment formula that they say is outdated and would have allowed steep cuts in Medicare payments if it had not been for repeated action by Congress to delay them" (Smith, 6/3).

The Wall Street Journal Health Blog: "In the call, Rohack echoed what experts told us yesterday — the longer the problem gets kicked down the road, the bigger the financial hole Medicare is in, and the less room there is to implement some of the health-care overhaul bill's initiatives to change reimbursement incentives" (Hobson, 6/3).

Modern Healthcare: "At a news conference, [Rohack] took Congress to task for not fixing the problem, which he said emerged as a 3% pay cut that would cost $49 billion to remedy in 2005 and has turned into a 21.2% cut and $210 billion problem today because federal legislators failed to solve the problem and merely voted to provide temporary funding 'patches'" (Robeznieks, 6/3).

The Portland (Maine) Press Herald: Maine Republican Sens. Olympia Snowe and Susan Collins are among the targets of the AMA. Although the "potential cut in reimbursements would not directly affect patients ... it would reduce payments to Maine physicians and hospitals by about $60 million a year, according to the Maine Medical Association. ... Maine doctors are hit harder by the Medicare shortfalls than physicians in other states because Maine has an older population and a higher percentage of patients who are covered by Medicare. And reimbursement rates are lower in Maine than in other parts of the country to begin with," said David McDermott, president of the Maine Medical Association. "Both Maine senators have called for reform of the Medicare reimbursement system, but maintained Thursday that it has to be funded [meaning deficit spending would not be used]" (Richardson, 6/4).

CongressDaily, in a separate story, looks at how the bill that the "doc fix" is attached to is became caught up in the growing concerns about deficit spending. The temporary Medicare reimbursement fix would cost $23 billion for 19 months. Other health benefits like an extension of a benefit to help the unemployed afford to keep their former employer's health insurance — called COBRA — and enhanced federal payments to states for Medicaid were dropped from the bill. "A senior Democratic aide said the deficit has become the overarching concern in many districts, more so than things like state Medicaid assistance and COBRA health insurance subsidies, both of which were dropped in the final bargaining. But in other cases, members voted 'no' largely because Medicaid and COBRA funds got the axe. Rep. Michael Capuano, D-Mass., was one example" (Cohn, 6/3).

KHN related coverage: Cobra Subsidy Starts Running Out For Some As Congress Grapples With Extension (Villegas, 6/3).