Physicians fight to preserve pay increase in Medicare bill

Preserving the House's payment update fix is key to maintaining patients' access, physicians say.

By Markian Hawryluk, AMNews staff. July 14, 2003.

Washington -- As congressional negotiators begin work on fusing massive House and Senate Medicare reform bills, physician groups plan a full-scale push to ensure the best of both is retained and the worst discarded.

At the top of the physicians' list is a reversal of projected cuts in Medicare payment for 2004 and 2005. The House-passed bill would replace cuts in each of the next two years with updates of at least 1.5% -- a 5.7 percentage point swing in 2004 alone. The bill also seeks to smooth out the volatility of the updates from year to year by linking them to growth in the gross domestic product over 10 years, rather than a single-year calculation.

Maintaining the update fix during negotiations over the bill will be crucial to the nation's health care system, according to Yank D. Coble Jr., MD, immediate past president of the AMA.

"This would really make it a much more realistic payment, and certainly help protect the access of the Medicare beneficiaries," Dr. Coble said. "It was clear that many offices simply could not take any new Medicare patients, and some were afraid they were going to need to close."

The Senate bill did not include a change in the physician update but was amended to include a measure proposed by Sen. Jon Kyl (R, Ariz.) that expressed the Senate's intentions that the update should be fixed. Kyl said it is extremely important that Medicare provides fair reimbursement to doctors so they can continue to serve the seniors who count on them. While it carries no legislative force, the support for a payment fix bodes well for retaining the House approach in the final version of the bill.