Congress gains time on Medicare cuts

The Baltimore Sun

CHICAGO - Amid intense political pressure from the nation's doctors, the Bush administration said yesterday it would hold off on a 10 percent fee cut in Medicare payments to doctors that was slated to kick in today.

The Bush administration is giving members of Congress time to prevent the reduction in payments from the federal health insurance program for the elderly when lawmakers return from a July 4 recess. The administration said the Centers for Medicare & Medicaid Services would not process Medicare claims for the first 10 days of the month, which would allow Congress time to reconsider a vote to stave off the cut.

A 10 percent reduction in payments could have big ramifications in the health care industry, with some doctors saying they could no longer afford to see Medicare patients. About 60 percent of physicians who responded to a poll by the American Medical Association this year said they would limit the number of new Medicare patients they see if payments are cut.

Dr. Kevin McCoyd said he and his colleagues in a three-member neurology practice in suburban Elmhurst, Ill., will discuss whether to take future Medicare patients at their next monthly business meeting.

"I don't know that we will change anything just yet, but I know of practices that have decided to say no more new Medicare patients," McCoyd said. "These cuts come off the bottom line because our expenses are not going away. We pay health insurance for our employees and have other costs."

The cut was scheduled to begin today after Medicare spending surpassed a ceiling that had been set by Congress as part of the Balanced Budget Act of 1997.

Meanwhile, doctors are taking their case to members of Congress, particularly Republican senators up for re-election this year.

In Texas, for example, the politically powerful Texas Medical Association late last week withdrew its endorsement of Republican U.S. Sen. John Cornyn, who is in a competitive battle for re-election, the Dallas Morning News reported.

In addition, AMA President Dr. Nancy Nielsen promised a "full court press" on lawmakers over the July 4 weekend. The AMA this week is formulating an advertising blitz pressuring several members of the Senate. The AMA has yet to disclose where it plans to run ads, but sources close to the national doctor group expect ads to run in states where Republican senators are facing re-election.

Congress regularly has restored the cut in the past, but lawmakers failed to do so this year. The House voted to delay the cut by an overwhelming margin of 355-59. But last week, the Senate failed by one vote to get the 60 votes needed to stave off the cut.

The AMA said Bush's action yesterday is only temporary.

"The 10.6 percent Medicare cut will take place on July 1, but Medicare claims will not be paid at the slashed rate in the first 10 days of July because under law Medicare holds claims for 14 days," Nielsen said. "In early July, Medicare will not be paying claims at the reduced rate because they are not paying claims. Unless Congress acts to stop the cuts, Medicare claims will begin to be paid at the reduced rate in mid-July."

The Bush administration, meanwhile, said it would hold "claims that are delivered on or after July 1," said Jeff Nelligan, a spokesman for the Centers for Medicare & Medicaid Services. "CMS will not be making any payments on the 10.6 percent reduction until July 15, at the earliest."

Bruce Jepsen writes for the Chicago Tribune.

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