Medicare Payments Facing the Ax
It's not the one everyone else is talking about in Washington, D.C., but Texas doctors are facing their own "fiscal cliff" come January 1st. Unless Congress takes action, Medicare doctor payments are set to drop by 27%, thanks to an automatic adjustment under the federal government's Sustainable Growth Rate (SGR) formula for Medicare funding. Dr. Michael Speer, president of the Texas Medical Association (TMA), says the SGR is a flawed formula that Congress has failed to address for nearly a dozen years. "We would like Congress to finally just pull up their pants and figure out how to fix this formula," he tells KTRH.
Instead of fixing the SGR, which was designed to control Medicare costs, Congress has simply passed a series of temporary extensions of the current funding rate, known as "doc-fixes." It's likely that another "doc-fix" is on its way in the next few days, but Speer and the TMA want a permanent solution from Congress. "Just say the formula's been retired, we made a mistake, we'll start from zero, let's go forward," says Speer. "I think they can find better things to spend their time on, and doctors certainly have better things to spend their time on, like seeing patients rather than worrying where their next payments will come from."
That uncertainty of not knowing what their government funding will be and the potential for drastic cuts in payments can literally drive doctors at the local level out of business, according to Dr. Speer. "Physicians can't plan for the future with regard to how to run the office, how many people can I hire, how much new equipment can I buy," he says. Texas has about 2.8 million residents on Medicare, and Speer argues they are the ones who could be affected if Congress doesn't fix the Medicare repayment formula. "We really want to take care of all patients here in Texas," he says. "But we have to have an office that's open in order to do that."