Rep. Wilson wants Medicare Physician Payments Addressed Before Year's End

Press Release

Rep. Wilson Wants Medicare Physician Payments Addressed Before Year's End

Excessive 10.1% cut for 2008 would jeopardize access to health care

Rep. Heather Wilson is urging House Speaker Nancy Pelosi to rethink an excessive ten percent cut in Medicare physician payments for 2008. According to Wilson, this significant reduction in physician reimbursements will make it even more difficult for seniors and disabled New Mexicans to access quality health care.

The proposed 10.1 percent cut for 2008, coupled with a 5 percent reduction estimated for 2009, will result in New Mexico's physicians losing $60 million for the care of elderly and disabled patients over the next two years. New Mexico's physicians will lose $930 million for the care of elderly and disabled patients by 2016.

It is estimated that 16,505 employees, 244,718 Medicare patients, and 86,538 TRICARE patients in New Mexico will be affected by these cuts.

New Mexico patients will be hard hit by the reduction since it already has a below-average ratio of physicians to Medicare beneficiaries and a below-average physician to population ratio. The state will also be facing an additional 1.6 percent cut next year because of an expiring geographical adjustment that has been in place since 2003.

In a letter sent to House Speaker Nancy Pelosi and Republican Floor Leader John Boehner today, Wilson said, "Before Congress adjourns in 2007, I would hope we can address the pending physician fee schedule reduction in a responsible manner that doesn't adversely impact spending in other parts of Medicare and simply shift the access problem from one area to another."

Medicare reimbursement rates are currently calculated by using the sustainable growth rate (SGR) formula, which Wilson has described as "flawed". Wilson supports a permanent fix to the SGR formula, but says a lack of consensus and political will has prevented action. Absent this permanent fix, Wilson wants immediate action to prevent the deep cuts proposed for 2008.

Wilson continues to take an active roll in providing seniors with more choices and better access to health care. Last year, Wilson joined 111 Members of Congress in urging then Speaker of the House Dennis Hastert to prevent Medicare physician payment reductions. At the time, at least thirteen New Mexico physicians had already opted out of Medicare. Physicians often cite uncertain payment rates and Medicare's onerous and burdensome regulations as reasons for refusing to see Medicare patients.

"Seniors depend on doctors for access to health care, and Medicare payment policies directly affect the ability of doctors to provide Medicare services. As a Member of the Energy and Commerce Subcommittee on Health, I am committed to working with my colleagues to find a permanent solution."

The physician fee schedule affects not just doctors, but also other providers who are paid according to the schedule. They include physical therapists, occupational therapists, psychologists, clinical social workers, certified nurse-midwives, nurse practitioners, clinical nurse specialists, physician assistants, and others.

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