Senate debate shifts to pay fix

A panel plans to consider reversal of Medicare physician reimbursement cuts next month, but reaching agreement on a prescription drug benefit could be trickier.

By Markian Hawryluk, AMNews staff. Aug. 19, 2002.

Washington -- Efforts to reform Medicare suffered a severe blow when the Senate failed to pass an outpatient prescription drug bill, but so far the damage hasn't hurt the drive to fix Medicare physician payment.

Senators left for their August recess after two weeks of fruitless debate over a prescription drug benefit. However, Senate Finance Committee Chair Max Baucus (D, Mont.) has indicated he would like his panel to vote on a Medicare practitioner payment bill as early as possible after the Senate returns in September.

Although details of the payment package were not available at press time, the overall spending level of the measure is expected to be close to the $30 billion over 10 years approved by the House in June. The House measure included $21.3 billion over five years to replace the deep cuts in physician reimbursement predicted for the next three years with payment updates of about 2%.

Meanwhile, the body of evidence showing that physician payment cuts are causing an access problem for Medicare services is growing. An annual survey by the American Academy of Family Physicians found that 21.7% of its members can no longer take new Medicare patients, up from 17% in 2001.

"My practice has been forced to quit taking new Medicare patients because the costs associated with treating them are increasing, while our reimbursement continues to go down," said Deborah G. Haynes, MD, a family physician from Wichita, Kan. "It's sad, because these are the patients who need us most."

The ultimate fate of the physician payment fix could still be linked to the Medicare prescription drug debate, which is likely to come up again in the Senate this year. Senators might be unwilling to pass Medicare payment increases without also adding drug coverage. [...]