Blue Dog Democrats Raise Concerns for Healthcare Reform
The Blue Dog Coalition, a group of fiscally conservative House democrats, has submitted a letter to Speaker Nancy Pelosi and Majority Leader Steny Hoyer outlining a number of concerns about the Tri-Committee draft health reform bill. American Society of Anesthesiologists (ASA) strongly supports the Blue Dog Coalition’s concerns about a public plan option based on Medicare payment rates.
ASA President Roger A. Moore, M.D., has released the following statement in response to the Blue Dog Coalition’s letter: “On behalf of ASA’s 43,000 physician members, I applaud the Blue Dog Coalition members and leadership for opposing a public plan option based on Medicare rates, and for recognizing that a Medicare-like public option would negatively impact doctors and patients. Further, I am pleased that the Coalition maintains that physicians and other health care providers should be able to voluntarily participate in the program, rather than being mandated by Congress.
“We are working together on one of the most comprehensive health care reform efforts this government has ever undertaken. We commend the “Tri-Committee” members and staff for their efforts toward meaningful and effective delivery reform. However, we believe that as part of responsible reform, we must ensure that a public plan option fairly compensate physicians for their services. As it stands, Medicare pays anesthesiologists 33 percent of what private insurers pay—a rate that simply does not cover the costs of providing anesthesiology medical care. An expansion of this inadequate payment system as proposed by the “Tri-Committee” would not be sustainable for private practice and academic anesthesiologists.
Medicare Proposes Ending Payment for Consultation Codes
The Proposed 2010 Medicare Physicians Fee Schedule Rule released by CMS last week included a bombshell hidden in amongst the 1128 pages: a proposal to discontinue reimbursement for the E/M consultation codes (CPT 99241-99255). These codes have been problematic for both physicians and insurers due to confusing and sometimes conflicting rules governing their appropriate usage. Over the years, Medicare has made numerous clarifications and code description changes to resolve the confusion. Now Medicare has decided to do away with the use of these codes altogether. Since consultation codes are reimbursed at significantly higher rates than regular office visit codes, CMS has proposed to increase rates for the remaining covered E/M codes to not penalize doctors while maintaining budget neutrality in their payments. If this proposal is implemented in November, it will become important that all physicians review their charges for E/M services (for both Medicare and commercial carriers) to ensure they are not undercharging Medicare for these visits and are in coding compliance if commercial insurers continue to pay for the consultation codes.
