The National Association of Health Underwriters recently published an article discussing the SGR (sustainable growth rate) which was a flawed formula that has caused Congress to scramble over the past few years for a Medicare Doctor Fix. The SGR was created in part of the Balanced Budge Act of 1997 to control the rate of physician’s pay in Medicare.
The cut to doctors pay started as a small percentage decrease which is now over 30% if the cuts were allowed to happen. Many think that politicians and lobbyists enjoy having this issue so they can raise money from a plethora of physician groups. It seems like Congress could get together regarding this Medicare doctor fix and create a solid 25 year solution instead of having an “emergency meeting” every year.
Medicare Doctor Fix
As mentioned above Congress gets together each year to come up with a fix but no long term solutions have been set in to place. Each year that this issue arises doctors tend to discuss pulling out of the Medicare market. Some do just because they do not want to have to handle all the red tape that comes along with Medicare claims and the low reimbursement rates.
We have heard doctors say they get paid 30% less for Medicare patients and have to do more work with the filing of claims. Then if something is entered wrong there is a chance of getting audited or having Uncle Sam bring down the hammer.
Why is the Medicare Doctor Fix a big topic?
Currently there are over 10,000 people a day turning 65 and that means over 3 million a year that are reaching Medicare eligibility (not including disability or end-stage renal disease beneficiaries). The elderly need doctors! Congress will have to figure something out in the years to come before they quit accepting new and possibly existing Medicare patients.
Medicare Insurance Finders has published this “Medicare Doctor Fix” article to help explain the importance of Congress to step up to the plate and figure out a long term solution to the SGR formula.