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Medicare Alert

4.2% Cut in Payments Projected: Tell Congress This is Unacceptable 
Physician groups are starting to gear up efforts to prevent an estimated 4.2 percent reduction in Medicare fees in 2004. Early indications are that there is limited support in Congress and the administration to prevent the reduction after helping physicians in 2003, which cost $54 billion.

What can you do to stop this from happening? Contact Congress to help prevent cuts in physician Medicare payments.  Go to www.acc.org and click on the "Take Action Now" icon in the lower right, and, after logging in, click on "Write Legislators" on the top menu bar. Unless Congress acts, physicians are slated to receive a 4.2 percent cut on Jan. 1, 2004.

The cause of this cut is a flawed formula that is used to calculate physician payments. Despite action by Congress and the Centers for Medicare & Medicaid Services (CMS) earlier this year to prevent a 4.4 percent cut from taking effect on March 1, the underlying flaws with the formula remain and will cause reductions in physician payments through 2008 if Congress does not intervene.

This volatility is forcing an increasing number of specialty physicians to reconsider their participation status, limit services, restrict the number of Medicare patients they will see, or retire early.  Without action from Congress, the instability in the current Medicare payment system will undoubtedly continue to chip away at the access to quality care that beneficiaries have come to rely upon. Again, please send your Congress members messages! Go to www.acc.org and click on the "Take Action Now" icon in the lower right, and, after logging in, click on "Write Legislators" on the top menu bar.


2003 FEE CUTS AVERTED!
Appropriations Bill Turns 4.4% Cut into 1.6% Increase

In perhaps the biggest legislative victory for physicians and their patients in recent memory, Congress has passed a provision as part of the omnibus FY 2003 appropriations package that will avert another cut in physicians’ Medicare reimbursement and instead provide a modest increase of 1.6 percent. Importantly, because of ACC-recommended technical corrections in the fee schedule, most cardiovascular specialists will receive a slightly larger increase of 2.2 percent on average.

“This victory is a true testament to what the ACC, other cardiovascular organizations, the AMA, the Alliance of Specialty Medicine, and other physician and nonphysician health care groups can accomplish if they are committed to an issue and work together through a sound strategy,” said ACC President W. Bruce Fye, MD. “Every ACC member who responded to the alerts to contact their legislators deserves to be congratulated, as does the College’s dedicated staff, who have worked tirelessly on Capitol Hill for nearly 18 months to make this happen.”

Although fees for most in-office procedures will increase, in-facility procedures will not do as well. In general, though, all cardiovascular-related procedures will see increases.

Echocardiography                     4.2%
Pacing/EP                                2.5%
Nuclear                                    4.6%
Interventional                            0.7%
General Cardiology                   1.3%
Total                                        2.2%

Because many cardiologists perform a mix of procedures, the overall impact on individual physicians will vary.

Thanks to the commitment of House Majority Leader Bill Frist, R-Tenn., House Ways and Means Committee Chair Bill Thomas, R-Calif., and Senate Finance Committee Chair Charles Grassley, R-Iowa, reached a deal to add a provision to the appropriations package that would be a 10-year fix and give the CMS the authority to correct erroneous estimates made in 1998 and 1999, when the CMS failed to account for nearly 1 million beneficiaries in calculating future payment updates.

It is unclear at this time how the change in fees will be implemented, but the College will make that information available to members as soon as the CMS provides further details. While it is also unclear what the exact effect of the fix will be in future years, it will undoubtedly be better than what the CMS had previously projected.


 

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