Action Needed As Doctors Face Massive Medicare Cuts | News, Sports, Jobs – To the world


Anyone reading the news knows that Congress is grappling with increasingly different opinions about what is right for this nation.

For those of us in West Virginia, we are grateful that Senator Joe Manchin holds the line against unqualified new issues.

As much as Senator Manchin has on his plate, I will boldly ask him to add another subject.

Doctors in the United States have a looming fiscal cliff that requires immediate action. You’re facing massive Medicare program cuts in less than two months.

The American Medical Association has been ringing the alarm bell for some time, and I add my voice to these efforts to urge Congress to act.

The details behind the cuts are complicated, but overall, medical practices are facing a 9.75 percent pay cut at Medicare as of Jan. 1, explained as follows:

n 2013 saw a 2% cut in Medicare reimbursements to doctors as part of a fundraising effort that required general cuts in government programs. These cuts have been frozen, but are set to resume from 2022.

n The American Rescue Plan Act 2021 resulted in a 4% cut in Medicare on what is known as PAYGO, another type of sequester used as a mechanism to offset the sharp rise in the federal deficit. This means that the Biden administration is paying for infrastructure expenses by cutting payments to doctors.

n The third problem is a change in the Centers for Medicare & Medicaid Services rating and management codes. CMS can change what it pays for services without the approval of Congress, as long as the changes are revenue-neutral.

When CMS decided to significantly increase the payments for outpatient and outpatient evaluation and management services from this year, it paid a 3.75% reduction for doctors from January 1st.

We need Congress to step in and prevent all of these cuts from going into effect within a few weeks.

Like other companies, doctors are just beginning to recover from the COVID-19 pandemic.

Inpatient visits to doctor’s offices fell by a third during the pandemic.

One in five medical offices across the country saw sales plummet by 50 percent or more, and eight in ten doctors have still not seen revenues return to pre-pandemic levels, according to an AMA survey of their members.

Medical offices are companies that employ a large number of healthcare workers, so low income affects staff and services, which affects patients. Remember, doctors, by and large, have no control over their prices – they only get what private insurance companies and government programs are willing to pay.

And by and large, government insurers reimburse providers at lower rates than private insurers.

In West Virginia, government insurance makes up a large portion of our patient base. More than 440,000 West Virginians – a quarter of the state’s population – are on Medicare, so a 9.75% cut in Medicare reimbursements will have a devastating impact on medical practices.

The AMA urges Congress to pass laws to prevent the fiscal cliff expected on January 1st. We also want Congress to hold hearings on how to permanently improve the Medicare physician payment system as we seem to be in an endless loop of looming cuts that will require Congressional intervention.

A meaningful reform of Medicare payments should include annual updates that accurately reflect the year-on-year increase in the cost of providing services. Medicare payments to facilities (such as hospitals) are updated in an inflationary manner every year, but no doctor payments.

I ask the entire West Virginia congressional delegation – Senator Manchin in particular – to step in and help the doctors keep their doors open. The world continues to grapple with a global health crisis caused by COVID-19, and now is not the time for the federal government to divert resources away from doctors.

Dr. Tom Takubo is a Charleston area pulmonologist and a majority leader in the West Virginia Senate.

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