“As you know, physicians and other health care providers are scheduled to receive a 27 percent cut on January 1, 2013, as a result of the flawed sustainable growth rate (SGR) formula. This is in addition to the 2 percent reduction included in the planned sequestration. Failure to adopt legislation to address the “doc fix” would create considerable instability in the Medicare program. Such a significant reduction in reimbursement could cause providers to stop seeing Medicare beneficiaries or prevent them from accepting new ones. We are disappointed that Congress has thus far been unable to develop a long-term solution to this perpetual problem. However, even in the absence of a longer-term solution, the SGR cuts must not be allowed to occur. Under current law, the Centers for Medicare and Medicaid Services may begin issuing the reduced payments on January 1. A reduction for even a short time in reimbursement rates could disrupt access to care, as providers may delay seeing Medicare patients until updated rates go into effect.
Video: Weekly Address: Preserving and Strengthening Medicare
FIne: Medicare and a dignified death
Although Medicare-covered hospice care has grown considerably over time, two major factors retard its effectiveness. First, patients who enter hospice care must forgo potentially life-prolonging therapies. That forces an untenable choice, and results in very late admissions to hospice. Second, the practice of medicine has evolved since the benefit’s eligibility criteria were established, requiring a physician to certify that a Medicare patient has a prognosis of six months or less.
Upton to Highlight Medicare Physician Payment Reform Effort WEDNESDAY During Address to American Medical Association
WASHINGTON, DC – Energy and Commerce Committee Chairman Fred Upton (R-MI) will address the American Medical Association at the 2013 National Advocacy Conference on Wednesday, February 13, 2013, at 8:00 a.m. at the Grand Hyatt Washington. Upton will discuss the health care law’s impact on physicians and patients and outline the committee’s upcoming plans to address the outdated Medicare physician payment system. Last week, Upton and Ways and Means Chairman Dave Camp (R-MI) released a framework of their collaborative efforts to repeal the Sustainable Growth Rate formula and advance a permanent solution for the long troubled payment system. On Thursday, the Energy and Commerce Health Subcommittee will hold a hearing on SGR reform.
Obama attacks sequestration, Medicare payments in State of the Union address
The President said he is willing to trim Medicare outlays to align with those proposed by the bipartisan Simpson-Bowles fiscal commission in 2010. He said this could be accomplished by shifting provider reimbursement to a pay-for-performance model, reducing subsidies to pharmaceutical companies and raising fiscal obligations for the nation’s wealthiest seniors.
Roadblocks Continue Despite Efforts To Address Causes of Hospital Readmissions
Bloomberg: Boomerang Patients To Penalize Hospitals Under U.S. Law Tenet Healthcare Corp., the third-largest U.S. hospital chain, keeps an eye on Medicare patients after they’re released. This isn’t just about professional integrity. Tenet has a financial stake in their well-being. Fines are being levied against hospitals with high rates of patient readmissions under a provision of the Affordable Care Act targeting $8 billion in Medicare cost savings within six years (Armour, 2/11).
Medicare Regularly Refills Pain Pills Without New Prescriptions: Government Report
To cut down on improperly refilled Medicare prescriptions, the report recommends that federal health officials automatically flag requests for reimbursement for controlled drug refills, and refuse to pay them. The Centers for Medicare and Medicaid Services should work more closely with providers, and follow up with those who have a large number of refills, the report recommends. The agency responded that working with individual providers and pharmacies is not an efficient use of resources, the AP reported.
President Obama Commits To Medicare and Medicaid In His Inaugural Address
The overarching theme of President Obama’s speech was that the government has to change to meet the changing needs of the people. “But we have always understood that when times change, so must we; that fidelity to our founding principles requires new responses to new challenges,” the president said. He provided an example of how American soldiers could not have met and defeated the forces of fascism or communism with muskets and militias. The president said, “We understand that outworn programs are inadequate to the needs of our time.” He continued by saying, “So we must harness new ideas and technology to remake our government, revamp our tax code, reform our schools and empower citizens with the skills they need to work harder, learn more, reach higher.”
Obama, Boehner Could Compromise To Address Looming Medicare Cuts
Shawn Gremminger — assistant vice president for legislative affairs at the National Association of Public Hospitals and Health Systems — said the Medicaid provider tax could be on the negotiating table as a cost-cutting measure. He noted that recent proposals have called for lowering the tax from 6% to 5.5%, which the Congressional Budget Office estimates would result in about $10 billion in savings over 10 years (Zigmond,
LBJ and the Initial Cost of Medicare
I’ll take care of that, I’ll do that. . . . When they asked me, do you want to put in anothe 400 or 500 million [to cover Mills’s Medicare expansion], . . . what did I say about it? . . . I said we had an old judge in Texas one time . . . we called him Al Caldy . . . old Al Caldy Roberts, and he said, when they talked to him one time that he might’ve abused the Constitution and he said, “What’s the Constitution between friends?” And I say, tell Wilbur that 400 million’s not going to separate us friends when it’s for health.
Obama Says Medicare, Medicaid ‘Free Us to Take Risks’ in Inaugural Address
President Barack Obama gave airtime to the need to reform healthcare entitlements in his second inaugural address Monday, but he defended their existence and pushed back on calls to make drastic cuts to the Medicare and Medicaid programs. “We must make the hard choices to reduce the cost of healthcare and the size of our deficit. But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future,” President Obama said. “The commitments we make to each other through Medicare and Medicaid and Social Security, these things do not sap our initiative, they strengthen us,” he continued. “They do not make us a nation of takers; they free us to take the risks that make this country great.”
Congress must address Medicare’s sustainable growth
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