Medicare

Legislation to remove current limitations on balance billing in the Medicare program

• Bill H.R. 4736 Text
• Letter to Representative Tom Feeney (R-FL)

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Medicare Physician Payment Cuts – Sustainable Growth Rate

Information about the 2007 Medicare Fee Schedule - [click here to download].

Medicare Cuts Averted

For more information, please

Finally, these scheduled cuts are on top of other cuts that took place in last year’s Deficit Reduction Act, which especially affected radiologists and will affect other specialties when the new Medicare relative value unit (RVU) formulas are adopted.

For more information concerning the scheduled Medicare cuts and their impact on New Jersey, see the following documents:

• Patient Flier
• Nationwide Impact
• Questions and Answers II
• Medicare Comparison to Other Providers
• Medicare costs vs. Payments - New Jersey impacts
• Medicare Physician Survey
• Questions and Answers

For information concerning physician participation options in Medicare see the following document:

• SGR - Participation Options

MSNJ Position: There is a consensus that the following changes are needed:

• Until a comprehensive solution is found, Congress needs to act immediately to prevent these cuts from taking place and to provide for an increase based on inflation;
• There is widespread consensus that the SGR formula needs to be replaced;
• The Medicare Payment Advisory Commission (MedPAC) has recommended that the SGR be replaced with a system that reflects increases in practice costs;
• A new Medicare physician-payment system is needed that adequately reflects increases in the cost of practicing medicine.
• As MedPAC and others have recommended, Congress should scrap the SGR formula and, instead, adopt the same approach for physician payment updates that is used for hospitals, nursing homes, and other Medicare providers. Under this approach, payments would accurately reflect practice cost increases.
• For 2007, MedPAC has recommended that Medicare physician-payment rates be increased by 2.1%.

MSNJ Action: MSNJ has been engaged, along with the AMA and state societies throughout the nation, in a public education and lobbying campaign to avert the upcoming payment cuts, provide a positive increase in 2007, and ultimately abandon the use of the SGR in favor of a system that increases payments to physicians based on increased practice costs and increased utilization.  In October, physician leaders from MSNJ traveled to Washington, D.C., and met with most of our congressional delegation. We secured their unanimous support to help fix this pending crisis.

Status: While significant progress has been made to bring our issues to the forefront of the congressional agenda, Congress has was not yet been able to come to a consensus on how to resolve this crisis. MSNJ plans to continue an aggressive lobbying and public educational campaign during December to prevent the scheduled 5% cut from taking effect in January. We have a limited timeframe to compel action in Congress. Once a resolution to the current crisis is accomplished, we plan to work on finding a permanent solution to the SGR and Medicare payment problems.

MSNJ urges its members and all patients to contact their congressmen and tell them to stop the Medicare payment cuts to physicians and provide a positive increase that reflects the costs of inflation.

With America's physicians and their patients calling for action, Congress on Dec. 9 passed legislation to prevent a scheduled 5 percent cut in 2007 Medicare physician payments, and instead freeze payment rates for one year.  For more information, please click here.

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