Update: Changes in Medicare For Physical Therapy

On Tuesday, June 24, 2008 the US House of Representatives pass the bill (HR 6331), Medicare Improvements for Patients and Providers Act. This bill will prevent a 10.6%  decrease in payment under Medicare's physician fee schedule and ensure our seniors the ability to continue their physical therapy treatment under the therapy cap exceptions process. The vote was 355 - 59. There are numerous other Medicare issues in this bill.
The legislation is now in the Senate and as of Friday, June 27, 2008, the bills S-3101 and S-3118 did not receive approval. Senator Reid inform the members of the Senate, there will be another vote on Sunday, June 29, 2008.  Hopefully the Senate will be able to negotiate a deal before Congress convenes on July 1,2008. If the bill is not pass before July 1, 2008, then there will be seniors who will not be able to continue their physical therapy treatment due to the financial cap. Yes, some seniors will be able to continue for number of reasons; they have a true secondary insurance policy or the ability to be a self pay. I'm sure there will be number of clinicians who will treat the patient for free. Of course the clinicians will receive a decrease in payment.  Now if the Senate decides to pass the bills sometime in July or after their summer vacation, the clinicians will be paid retroactive from July 1, 2008, this will be accounting nightmare. Plus the most important issue, what about the patients who did not receive treatment?   Again Congress at its finest. Can you image if we operated our businesses or companies similar to Congress....we would be out of business. This will be another topic in the future.

Comments

[Tim Richardson]

Here is the response from the American Medical Association to Friday's Senate vote:

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Statement Attributable to:
Nancy H. Nielsen, M.D.
President, American Medical Association

"The physicians of America are outraged that a group of Republican senators followed the direction of the Bush Administration and voted to protect health insurance companies at the expense of America’s seniors, disabled and military families.

"These senators leave for their 4th of July picnics knowing that the most vulnerable Americans are at risk ...

"...Today, thanks to some senators, we stand at the brink of a Medicare meltdown. On July 1 – just four days from now – the government will slash Medicare physician payments by 10.6 percent, forcing many physicians to make the difficult choice to limit the number of Medicare patients in their practices.

"The Senate must return from their recess and make seniors’ health care their top priority. For doctors, this is not a partisan issue - it's a patient access issue."

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While I agree with the facts of your post I wonder if the rhetoric of the AMA well serves the American public (especially the 46 million uninsured, mainly women and kids).

Instead of bi-annual(we went through this in December 2007 - remember?) 10% Medicare cuts why not a 2% annual reduction in the Medicare Physician's Fee Schedule?

Everyone knows the direction federally funded healthcare reimbursement has to go.

Large cuts inevitably trigger PAC funding and large-scale lobbying to reduce or reverse the cuts.

More money is not the answer.

One solution to the healthcare "crisis" is to dissolve the unholy alliance of providers, payers and patients.

Tim Richardson, PT

timrichpt@physicaltherapydiagnosis.com

www.physicaltherapydiagnosis.com (blog)

[Diane]

Tim,
Thanks for your comment. I believe we can fix the health care crisis. Cutting fees every year by 2% will hurt everyone in the long run. If we cut fees every year then do we not give raises to our staff or buy new equipment. Health care needs to change.Maybe we need to become outcome driven and yes leave room for gray areas. Example instead of Medicare having a cap of a certain financial limit, we can develop a system based on conditions and outcome. Maybe have a set fee determined by geographic location and a bonus system for outcome. Just some of my ideas.