Doctors rally over Medicare payments

By ED SUSMAN, UPI Science News  |  Dec. 10, 2002 at 4:39 PM
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NEW ORLEANS, Dec. 10 (UPI) -- With the theme from the movie "Rocky" reverberating through the assembly hall, normally sedate members of the American Medical Association chanted, waved signs and paraded with slogans Tuesday, demanding that Congress fix an error in calculating Medicare payments.

The acknowledged error already has resulted in a 5.4 percent reduction in payments to doctors who perform services for seniors, and additional cuts will occur if the error is not fixed.

The AMA's House of Delegates, the policy-making body representing 270,000 doctors in the United States, passed a resolution calling for a series of interventions to bring the issue to the attention of Congress -- and in particular the attention of the U.S. Senate, which has blocked attempts to rectify the accounting error.

The resolution authorizes the AMA to use legal maneuvers if necessary to change the flawed formula, although AMA President Yank Coble, of Jacksonville, Fla., said litigation "is not now on the front burner."

Wearing white coats distributed by AMA staff and T-shirts emblazoned with the slogan: "Fix the Medicare Mistake now," doctors carried on spirited rally for about a half-hour immediately after passage of the resolution.

The rally was spearheaded by emotional talks from Dr. John Armstrong, a surgeon at Brooke Army Medical Center in San Antonio and a member of the AMA Board of Trustees. Armstrong said not only does the Medicare mistake affect senior citizens but the payments also are tied to formulas that establish payments to the doctors who treat Armed Forces dependents and retirees.

"We must make sure that we protect the access of medical care to those who have given and are giving so much are not going to be given too little," Armstrong said to cheers and applause. "Let's work to send this message to our troops: Your family and loved ones back home are getting the care they deserve."

Then Robert McMillan, a lawyer from Melville, N.Y., and the only non-physician on the AMA board, asked the delegates: "Are you ready to go to war over the Medicare Mistake?" His call for action was greeted with thunderous responses. He urged the delegate-doctors to get on the front lines of the battle.

Vice speaker of the House of Delegates, Dr. Nancy Neilsen, an internist from Buffalo, N.Y., told the delegates to turn on their cell phones and begin calling Congressmen to get some action taken.

The resolution, which was passed by acclamation, calls for the AMA to:

-- Ask physicians and their patients to contact their every U.S. senator, noting physician anger and frustration with the Senate for failing to correct the documented error in physician payments under Medicare;

-- Work with state medical societies and national specialty societies to distribute materials, to be displayed in physicians offices, alerting patients of the problem and placing blame for the problem at the feet of their senator;

-- Coordinate a "fly-in" in early January with state and national medical societies to urge Congress to enact legislation necessary to change the errors and avert additional Medicare cuts;

-- Arrange "mini-internships" that would put members of Congress in a doctor's office for a day to see what problems the payment cuts are causing; and

-- Promote aggressively expanded grassroots participation in how the Medicare cuts affect them.

The problem with the pay cuts occurred in 1998 when government agencies erred in calculating benefits and payments to doctors. That resulted in a 5.4-percent reduction in payments for Medicare service in the year 2002. Attempts to fix the problem by creating legislation that would allow the errors to be corrected failed in 2001. The events of Sept. 11, 2001 and the subsequent military actions in Afghanistan and anthrax attacks diverted attention from the issue in the Senate.

The AMA thought the problem would be corrected in 2002 and found support in the House of Representatives, which twice voted for legislation that would have allowed a solution. But the Senate -- despite 81 co-signers of similar legislation -- never took a vote on the issue.

Rep. Billy Tauzin, R-La., responding to the AMA action Tuesday, said in a statement: "Congress and the White House have a crisis on their hands. Across the country, Medicare patients' are losing access to their trusted physicians due to drastic payment reductions caused by a fatally-flawed physician payment formula."

Dr. John Nelson, an obstetrician from Salt Lake City and a member of the AMA Board of Trustees, said: "We are putting on a full court press to make sure that this mistake, this meltdown, this problem, this lie is fixed. We are very concerned and we want the world to understand along with our physicians that we get that a terrible error has been made. We are very angry, we are outraged by this. It is unfair. It is not fair to doctors, it is not fair to patients, it is not fair to our country."

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