The organizations want Congress to find a permanent solution to the sustainable growth rate (SGR), the formula used to determine Medicare physician payments, and replace it with a system that can keep pace with the cost of caring for seniors. Thus far, Congress has chosen to delay cuts using short-term, stop-gap measures.
The letter notes that the next payment reduction comes “during the period when physicians may change their status from a Medicare participating physician, who accepts Medicare’s allowance as a payment in full, to a non-participating physician who may bill patients more than the Medicare allowance.” The perpetual uncertainty regarding Congressional support for the Medicare program has caused many physicians to either leave the Medicare program or restrict the number of Medicare patients they see. This poses a risk to access for seniors, especially in rural areas where smaller practices often serve a larger than average number of Medicare patients and cannot afford large cuts in Medicare physician payments.
The NCMS is urging its members to contact their US Representatives and Senators today and urge them to act in the first week of the lame-duck session of Congress to avert a Medicare physician access crisis.