July 1, 2008

Medicare Cutback is Put on Hold As Congress Recesses


The Bush administration on Monday delayed a 10 percent cut in Medicare payments to doctors to give Congress time to reach an agreement on how the cuts can be restored.

But North Jersey doctors wonder if relief will come and say they think twice before taking on a new Medicare patient.

"You're going to see more and more doctors not accepting Medicare patients," said Dr. Charles Moss, a vascular surgeon. "If it's a choice between a patient who can pay you and a Medicare patient, what are you going to do?"

A measure to rescind the 10.6 percent cuts failed by two votes in the U.S. Senate on Thursday, with Sens. John McCain, the presumptive Republican nominee for president, and Edward M. Kennedy, recovering from brain surgery, absent. Both of New Jersey's senators voted for rescinding the cuts.

President Bush had promised a veto after the House of Representatives earlier passed the measure by a large margin. Bush opposes the plan, which would restore the reimbursements by cutting federal payments to Medicare Advantage, or managed care, plans.

While there was no assurance that the Senate will work out a compromise after it returns from the July 4 holiday, the federal Centers for Medicare and Medicaid notified doctors that it would not process any claims for the first 10 business days of July.

The hold would give Congress time to act and "avoid any disruption" in services, a statement said.

A state advocacy group for older people thanked Sens. Frank Lautenberg and Robert Menendez for their votes. But AARP New Jersey's president, Sy Larson, said he was disappointed by the failure to enact a law protecting 44 million Americans and 1.3 million New Jerseyans who depend on Medicare.

The concern is that doctors will withdraw from Medicare or limit the number of patients they see with Medicare coverage. Some new patients may find it hard to find a doctor who accepts Medicare. Or they may find office waits longer, as physicians squeeze more patients into the workday.

"The patient is the one caught in the middle," said Michael Kornett, chief executive of the Medical Society of New Jersey. "They didn't create this situation." The cuts are triggered by a complex formula; Congress has succeeded almost every other year in restoring the money.

Though there were no signs of movement Monday, it appeared unlikely that Congress would risk alienating senior citizens in an election year.

For doctors, the impasse in Washington was a bitter reminder that as small businessmen they have little control over revenue or expenses. Those who treat diseases found primarily in the elderly will be hit the hardest, said Dr. Ron White, a Bergen County surgeon and president of NJ Physicians, a new advocacy group.

Their practices will be doubly affected, because many managed care companies peg their payments to Medicare rates, he said.

"I think physicians will reconsider how they are going to deal with their Medicare patients," he said. "They can't fill up their office hours with all Medicare patients."

The economic environment for physicians in New Jersey is tough, White said, because malpractice premiums are high, reimbursement for charity care is nil, and managed-care companies dominate.

(c) 2008 Record, The; Bergen County, N.J.. Provided by ProQuest Information and Learning. All rights Reserved.