Congress this week reached an atrocious new low in its recent handling of Medicare reimbursements to physicians.
The Centers for Medicare and Medicaid Services this week began enforcing a 21 percent cut in physician Medicare payments. An estimated 50 million claims were affected. The scale of the disruption, although temporary, is unprecedented.
By law, the cuts were supposed to go into effect on June 1. CMS held off actually making the cuts as long as it could on the assumption that Congress would get around to reversing the cut, as it has done repeatedly in the past.
The expected reversal was delayed because Senate Majority Leader Harry Reid for a time held physician reimbursements hostage, trying to use the issue as leverage to round up votes for a stimulus spending bill. Then he suddenly pulled physician reimbursement funding out of the stimulus package; it quickly passed on a separate vote. Reid's decision surprised and irritated House Speaker Nancy Pelosi, who refused to allow a House vote, until finally relenting on Thursday.
With Congress at an impasse, CMS officials on Monday said they could wait no longer. The most immediate effect is that doctors all across the country, including those in Lincoln and elsewhere is Nebraska, will receive checks
21 percent lower than anticipated. Those hurt the most will be doctors with a high proportion of Medicare patients.
"The damage has been done," Robert Doherty, senior vice president of governmental affairs and public policy for the American College of Physicians, told the Wall Street Journal's Health Blog. "This has created a lot of havoc, and it's a bigger issue than the two or three or four days when claims were being processed at these (21 percent lower) levels."
Dr. Cecil B. Wilson, president of the American Medical Association, said in a statement that Congress was playing "Russian roulette" with seniors' health care.
"This is no way to run a major health coverage program," he said.
The current spectacle of congressional ineptitude may persuade more physicians to limit the number of Medicare patients they see. The number of physicians refusing to see new Medicare patients already is setting a new high, according to USA Today.
The refusal by Congress to act comes with a price tag of its own. Assuming that Congress eventually will revoke the cut, the claims will be reprocessed at a cost of about $15 million, based on CMS estimates.
Both major political parties share blame for creating the current mess. In 1992, Congress approved a formula for determining reimbursement rates. In 2001, Congress started approving fictitious cuts in Medicare fees in order to make the federal budget look better. Since then, for nearly 10 years, Congress continued to make fictitious cuts, and then negated them with "temporary" delays. Now the accumulated gap is 21 percent.
Democrats refused to address the problem while shoving the health reform package through Congress. Covering the real cost of Medicare would have made it impossible to claim that the reform package would lower annual deficits.
So the problem persists. It will stay that way until Congress finally puts aside brinkmanship and political games and goes to work on a long-term solution.