June 28, 2012
The Pinellas County Medical Association’s President Tim Carlson MD, released the following statement today regarding the Supreme Court’s decision on the Patient Protection and Affordable Care Act.
The Pinellas County Medical Association (PCMA) mission is to inform, serve and advocate. The PCMA feels that the health care system should be focused on the needs of patients. Our purposes are to further the prospects of providing high quality medical care, to ensure access to health care for all patients and to promote and monitor the ethical and competent practice of medicine. The PCMA continues to be concerned about the quality of care of patients, and the resulting financial impact on our society. We will continue to emphasize the utmost standards of medicine for patients.
The PCMA will continue to monitor the impact of the Supreme Court’s decision on physicians and on the delivery of medical care.
Congress: Fix Medicare pay formula for good
Congress is headed for another showdown over extending the payroll-tax holiday for 160 million Americans, but that might be an easier impasse to settle than another one lurking for lawmakers.
A 27 percent cut in payments to doctors under Medicare will kick in next month unless Congress stops it. Groups representing doctors have warned that if the ax falls, many of them will start turning away patients covered by the program, which serves nearly 50 million senior citizens and people with disabilities.
It'd be reckless for Congress to dismiss such warnings as a bluff. Lawmakers have no responsible choice except to act.
But this time, they need to come up with a permanent solution, not a temporary one that will only mark time until the next cliff-hanger for doctors and patients.
The issue is especially critical for Florida, where more than 3 million people depend on Medicare for their health care.
Under a formula Congress approved in 1997, doctors get an automatic cut in their reimbursements from Medicare if spending on the program exceeds a target tied to economic growth. Lawmakers began postponing the cuts in 2003, and have done so regularly since then. It's known as the "doc fix" in Washington, D.C.
The gap between current reimbursement rates for doctors and the level called for under the 1997 law has now widened to a chasm of 27 percent. Congress hasn't repealed the formula because it would balloon budget deficits, or force lawmakers to cut other programs, or raise taxes.
The periodic suspense that has led up to doc fixes has created financial uncertainty for doctors and anxiety for patients. And every year Congress puts off a long-term solution, the budget hole gets deeper.
Repealing the formula in 2005 would have cost less than $50 billion over 10 years. Getting rid of it now would take about $300 billion. Wait until 2016 and the tab climbs to almost $600 billion.
Rather than temporarily fix a broken formula, lawmakers need to junk it. And they need to cover the cost with real Medicare cuts, not budget gimmicks. In 2010, President Obama's bipartisan fiscal commission came up with Medicare reforms whose total savings, nearly $400 billion, would be more than enough to do the job.
Ditching the formula makes sense for medical and financial reasons. Medicare pays doctors based on the quantity of services they provide, not quality. A new formula that creates incentives for keeping patients healthy is long overdue.
Doctors and patients would benefit from a new formula. So would taxpayers. Congress must make the next doc fix the last.
2012 Legislative Update
Senate Health Regulation has several bills up Wednesday afternoon, two of which we are trying to kill outright -- SB 7186 (balance billing and price transparency) and SB 850 (pharmacy vaccines). Click on the pdfs below to view Talk Sheets on all. Committee members are Senators Garcia, Gaetz, Fasano, Norman, Jones, Diaz de la Portilla and Sobel.
The committee will also take up the DOH ESO bill, SB 594 by Storms. It is my understanding there will be an amendment to reflect the current status of our negotiations with the DOH on this bill. I have not yet seen this language. I expect that it will limit the ESO to a restriction on prescribing Schedule II – IV drugs and require a Probable Cause Panel to convene within 10 days. If amended, the bill will be a substantial improvement but we’ll need to keep working on it. We are still opposed and not ready to sign off on it at this point. We’ll have an update on where things stand in Dr. Dunn’s next Friday letter.
I have reason to believe that Rep. Wood’s Health & Human Services Quality Subcommittee will also hear the House pharmacy bill on Wednesday. This will be a really close vote. Key legislators on this committee: Renuart, Ford, Gonzalez, Nunez, Oliva, Rooney, Schwartz, Mia Jones, Randolph, and Reed.
Finally, PIP bill, HB 119, will be up in the House Civil Justice Committee Wednesday. We oppose caps on attorneys fees and provisions of the bill giving insurers virtual unfettered discretion in obtaining examinations under oath. The bill essentially limits PIP coverage to emergency medical services rendered in an ER (with a few narrow exceptions). As drafted this provision needs work but we think this part can be fixed.
FMA Legislative Wrapup
Office of the Attorney General, Dave Aronberg - Special Prosecutor, Prescription Drug Trafficking
"Prescription Drug Abuse - Florida's Health Crises"
Download PCMA's Legislative Dinner Meeting guest speaker - Dave Aronberg's presentation....