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Texas physicians petition Congress to fix Medicare funding

Doctors, patients and others are worried about the state of the program

04/05/2010 9:14 PM

04/06/2010 1:01 PM

This time, you could read their signatures.

In bold, clean strokes, North Texas physicians inked their names to a statewide petition drive Monday urging Congress to permanently fix the gap in Medicare funding that they say could cripple the system.

The petition by the Texas Medical Association, launched Monday in seven locations across Texas including Fort Worth, warns congressional leaders that some physicians could be forced to stop accepting Medicare patients if a permanent fix cannot be worked out.

The group is urging Texans from all walks -- not just doctors -- to sign the online petition at www.MeAndMyDoctor.com. Medical societies in 10 other states have agreed to join the Texas initiative, and another 30 state groups have expressed interest, officials said.

"My colleagues and I want to continue to take care of our Medicare patients," said Dr. Susan Rudd Bailey, a Fort Worth allergist and president-elect of the state association. "This is a problem that Congress has known about for a long, long time."

A 21.2 percent cut in Medicare payments to physicians went into effect April 1 after the latest in more than a decade of stopgap measures from Congress expired. A new temporary measure is expected to be approved in the next week or two in Washington, but physicians say that is not enough.

"We need more than Band-Aids," Dr. William H. Fleming III, a Houston neurologist and president of the state association, said at an event in Houston. "We need more than sutures. We need a complete transplant ... Medicare patient access to care is in jeopardy across Texas and America, and we must send a clear message to our leaders how urgently we need them to step up and stop the Medicare meltdown now."

Texas officials are hoping to deliver a petition with 1 million signatures to Congress and the White House.

What's happening

The funding cuts that went into effect April 1 are unrelated to the recently passed healthcare reform legislation. Instead, they stem from the balanced budget provisions approved by Congress in 1997, when Medicare payments to physicians were tied to a funding formula based on a complicated "sustainable growth rate." But two recessions and other economic problems over the past decade have resulted in required cuts to physician payments in most years even as healthcare costs and operating expenses have increased, physicians say.

Congress has repeatedly postponed the cuts, allowing them to build to the current levels without ever changing the way payments are calculated. Payments of Medicare claims have been put on hold temporarily to allow Congress time to act once again on postponing the cuts.

If allowed to stand, the cuts would mean that physicians would lose an average of $13 every time they treat a Medicare patient, according to the Texas Medical Association. Payments to physicians have lagged sharply behind Medicare payments to hospitals and nursing homes, which use a different funding formula, according to the association.

The estimated cost to fix the funding gap is more than $200 billion.

Patient concerns

Dr. John Flores, a primary care physician in Little Elm and president-elect of the Denton County Medical Society, said many of his Medicare patients are worried about being able to find a doctor who will treat them.

"They're worried and anxious that I'll no longer be able to take Medicare patients," he said. "This isn't just a few lone voices in the wilderness."

Dr. Rex Hyer, president of the Tarrant County Medical Society, said the temporary measures are not adequate.

"We spend so much time and energy getting a patch that Congress dodges the bullet on getting a fix," he said.

Bailey said the funding uncertainty has prompted many doctors to refuse to accept new Medicare patients.

"It's really difficult to do business when there's so much uncertainty about how you're going to get paid," she said. "Some doctors are opting out of the Medicare program altogether. Some doctors are stringing out the number of Medicare patients they see in a week or a month. Some are just retiring early."

Texas has about 2.5 million Medicare recipients, including senior citizens and people with disabilities. The funding formula also applies to payments to 850,000 military families covered by TriCare. The Texas Medical Association represents about 45,000 physicians and medical students.

DIANNA HUNT, 817-390-7084

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