The Senate voted 78-19 late Tuesday evening to pass H.R. 4691, the Temporary Extension Act of 2010, which included provisions to extend 2009 Medicare physician payment rates through the end of the month. As a result, the 21% payment cut that took effect on March 1 has been postponed until April 1.
As Congress was preparing to act on 4691, NCMS President Douglas Sheets, MD, and CEO, EVP Robert Seligson were in Washington, DC lobbying members of the N.C. Congressional Delegation to support a permanment fix of the sustainable growth rate (SGR), the formula used to establish Medicare physician reimbursement rates. Also attending the 2010 National Advocacy Conference were Ophelia Garmon-Brown, MD, MDiv, President, Mecklenburg County Medical Society (MCMS); Robert “Bob” Schafermeyer, MD, President-Elect, MCMS; Carolyn Scruggs, Executive Director, MCMS; and William W. Truslow, MD, President-Elect, Greater Greensboro Society of Medicine.
After the President signed the bill, the AMA reported that discussions were underway in the House and Senate on the next steps that will be taken to address the Medicare payment crisis. Proposals are being circulated that would implement still another short-term patch to the sustainable growth rate (SGR) formula, including proposals that would postpone cuts for 90 days, 7 months, or through the end of 2010.
Yesterday, AMA President J. James Rohack, MD, sent a letter to all members of the Senate, urging them to use the 31-day reprieve from the 2010 Medicare physician payment cut to delovop a legislative pathway toward a permanent repeal of the SGR formula. The NCMS and the AMA continue to press for the repeal rather than repeating the pattern of short-term remedies that serve to make future payment cuts more severe and increase the cost of permanent Medicare reform.
This week US Representatives Bob Etheridge (D-NC Dist. 2) and Walter B. Jones (R-Dist. 3) responded to letters sent by the NCMS urging them to support HR 3961, the Medicare Physician Payment Reform Act.
Physicians are urged to keep up the pressure, especially in the Senate, for enacting legislation to permanently resolve the Medicare physician payment crisis. Use the AMA’s Grassroots Hotline: 1-800-833-6354 or go to the NCMS Legislative Action Center to contact your Senators or Representatives.
Yesterday, Dr. Tony Caprio and I spoke to fourth year medical students at the UNC School of Medicine. They were attending a “Capstone” course, which includes some final words of wisdom before they graduate after four years (or more) of hard work and venture into their training programs. There was some very positive energy in the room—they were too excited to be nervous yet! Speaking to them the morning after the Senate passed a 30-day SGR Stopgap on Medicare cuts, I asked them to imagine that they had awakened that morning and had their pay cut by 21%. Now, on top of that, their bills and overhead expenses were increasing, but their patient care was devalued by 21% overnight. I explained the role that NCMS is playing in advocating for a permanent fix to the SGR, along with our many other advocacy efforts.
I’d like to thank Dr. Caprio for encouraging them to join and support their professional organizations. Dr. Caprio related his own sense of intellectual and social fulfillment gained through his involvement in his state and county medical societies. He educated them about the many services available to members and described the NCMS as a “One Stop Shop” for medical practice needs. Thanks, Dr. Caprio!
Capstone Director Dr. Ana Felix, Dr. Caprio and I challenged these almost-new doctors to claim their rightful control of the medical profession. With Match Day less than two weeks away, new graduates are entering medicine during one of the most challenging times in history. I hope these new physicians will fulfill the need for physician leadership and activism in the delivery of healthcare. Good luck to the Classes of 2010 at UNC, Duke, WFU and Brody. It is your time to shine as you begin your honorable careers.
Shawn Scott, Assoc. Deputy EVP/Director, Member Services
On Thursday March 11, at 5:00 PM EST, Brenner Children’s Hospital of Wake Forest University Baptist Medical Center will broadcast a presentation of a life-saving procedure, Esophageal Atresia.
Esophageal atresia is a rare congenital disorder in which the esophagus does not develop properly. This disorder is often detected before birth through ultrasound examinations.
The President signed HR 4691 into law late Tuesday, March 2, which contained a one-month stopgap provision to override the 21% Medicare rate cut called for by the flawed Sustainable Growth Rate (SGR) formula. Under this bill, the Medicare conversion factor update is set at 0% through March 31, 2010. Your NCMS President, Doug Sheets, MD, and Executive Vice President/CEO Bob Seligson have been in Washington, DC this week lobbying for a permanent solution to the perennial SGR problem. Organized medicine supports legislation to permanently replace SGR with a more realistic approach to Medicare payment updates.
On Thursday the U.S. House passed HR 4691, legislation that extends a number of expiring programs for 30 days, including current Medicare physician payment rates. The Senate unsuccessfully attempted to pass similar legislation by unanimous consent on Friday morning. The Senate has now adjourned for the weekend, so the 21% Medicare physician payment cut will be effective on Monday, March 1st. We have been notified that CMS is notifying their contractors to hold Medicare physician claims for 10 business days, starting Monday.
Delaying a permanent fix through a series of temporary patches in the past has sky-rocketed the cost of a permanent solution, and has fueled this partisan standoff. The NCMS encourages you to contact Senators Burr and Hagan to let them know that this cut threatens patient access and will irreparably destabilize Medicare. Congress has neglected to address this issue for nearly half a decade. Now is the time to permanently fix the SGR so that the elderly and needy do not go without medical treatment.
NCMS leadership and staff will be in Washington, D.C. next week meeting with the North Carolina Congressional Delegation on this very serious issue.
The NCMS received word this week that the FDA has initiated a Risk Evaluation and Mitigation Strategy (REMS) for erythropoiesis-stimulating agents (ESAs). Please let us know your views on the effect of this initiative on physicians and patients.
The FDA has determined that a REMS is necessary for ESAs to ensure the benefits of these drugs outweigh the risks of shortened overall survival and/or increased tumor progression or recurrence as identified in clinical studies in patients with breast, non-small cell lung, head and neck, lymphoid and cervical cancers.
As part of the REMS, a Medication Guide explaining the risks and benefits of ESAs must be provided to all patients receiving ESAs. To ensure continued access to ESAs for healthcare providers who prescribe, or prescribe and dispense, ESAs to patients with cancer, providers are required to train and enroll in the ESA APPRISE (Assisting Providers and cancer Patients with Risk Information for the Safe use of ESAs) Oncology Program and to document that a discussion about the risks of ESAs took place with each patient prior to the initiation of each new course of ESA therapy. The ESA APPRISE Oncology Program will be launched on March 24, 2010. Direct patient registration or approval prior to ESA administration is not required through the ESA APPRISE Oncology Program.
The goal of the ESA REMS is to support informed decisions between patients and their healthcare providers (HCPs) who are considering treatment with Aranesp, EPOGEN or PROCRIT educating them on the risks of ESAs. For treatment of patients with cancer, the goal of the REMS, as implemented through the ESA APPRISE Oncology Program, is to mitigate the risk of decreased survival and/or poorer tumor outcomes.
The era of celebrity physicians and TV diagnoses has also spawned a generation of professional physician-bloggers, several of which sincerely stand out from the crowd with compelling questions, informed opinions, and thought-provoking perspective.
And as more and more of your patients are spending time online – often researching information specifically about healthcare and local physicians – it’s worthwhile for our NC medical students and doctors alike to consider remaining apprised today’s more popular doctor-blogs.
Here’s a snapshot of the most popular medical blogs on the Web – and if you’ve considered beginning a blog of your own to better connect with customers, these all serve as terrific reference points and examples of success.
Grunt Doc (http://www.gruntdoc.com) – A former USMC Doctor, the Grunt Doc recounts the stories – good and bad – he’s lived as attending EMD. Thought provoking, heart-warming, enraging and at times desperately sad, Grunt Doc spares no emotion when he tells the truth about what goes on behind closed hospital doors.
KevinMD Blog (http://www.kevinmd.com/blog/) – A primary care doc in New Hampshire, Dr. Kevin Pho offers down to earth and realistic commentary which on medical news, legislation, and hot topics his views on CPR to commentary on Medicare and H1N1.
Paging Dr. Gupta (http://pagingdrgupta.blogs.cnn.com/) – No stranger to the limelight, CNN’s Dr. Gupta offers a global context for developments in medicine and healthcare. Always an interesting perspective for NC doctors and medical students to explore.
In the Pipeline (http://pipeline.corante.com) – Dr. David Lowe spends a great deal of time discussing drug development, the drug industry as well as looking at illnesses such as Alzheimer’s and Autism. Standing on the forefront of drug research, he provides a valuable perspective about the pharmaceutical industry in general.
What do you find you’re reading on a daily or weekly basis? Have you started a blog to connect with patients or share your own commentary? Let us know.
UnitedHealthcare has revised its Claim Reconsideration Request form for contracting physicians, hospitals, and other health care professionals. The minor changes are meant to clarify that claim reconsideration is not part of UHC’s Formal Appeal process and that this form should not be used for appeals or new claims. UHC will continue to accept earlier versions of the form. More information is available here, and you can access the form itself here.
Are you retired or planning for retirement? Does volunteerism fit into your retirement plans? The NCMS is seeking feedback on a 60-second survey about the interests of our retired members. Let us hear from you! Click here to participate.
