What Healthcare Reform Means for Your Doctor (Long Term)

In the short term, the doctors are upset.  On Friday, the U.S. Senate held floor debate on H.R. 4851, which would have extended a number of expiring programs through April of this year.  The bill, which had already passed the House, included a critical piece of legislation the doctors have been requesting for some time – an extension of current Medicare physician payment rates.  Without the extension, the 21.3 percent cut scheduled for April 1 will go into effect.  The bill was tabled until after the Easter Recess.

While the extension was laid on the table for the Easter recess, it does not appear the will of Congress is being acceded.  Rather, Senator Tom Coburn (R-OK) again started his one-man filibuster of the bill’s passage since he feels that the extension should not be considered “emergency spending,” which is exempt from budgetary offsets.  It is expected that the Senate will hold a cloture vote after the Easter Recess.  If supported by 60 senators, the legislation will be approved.  The vote is scheduled for April 12.  I will be surprised if the extension does not pass the Senate.  So, while there’s a glitch in the process and the extension does temporarily expire, expect resolution after Easter.

For the longer term, I thought it would be important to cover some of the highlights from the healthcare reform legislation that affect the doctors. So, here is an overview:

• Medicare Payments
• 10 percent incentive payments for primary care physicians beginning in 2011
• 10 percent incentive payments for general surgeons performing major surgery in health professional shortage areas beginning in 2011
• 5 percent incentive payments for mental health services beginning in 2010
• Beginning in 2010 a new “floor” will be established on Medicare’s geographic payment adjustment to benefit physicians in rural and low cost areas
• Medicaid Payments
• Within the reconciliation bill, Medicaid payments to family practice doctors, general internists, and pediatricians will all increase and the federal government will fund 100 percent of the cost for states to make the change.
• Administrative Changes
• New rules are being implemented to standardize the insurance claims process, making it easier for doctors to track claims and improve their revenue cycles with less overhead costs.
• Medical Liability Protection
• Under the new healthcare reform law, the Secretary of Health and Human Services will award five-year grants to states in order to help create, implement, and analyze medical liability reform programs beginning in 2011.

To bring it full circle, anticipate that during the Easter Recess Members of Congress will be hearing from their physicians on both the extension, or “doc fix,” and on how they did on the healthcare reform legislation.  The American Medical Association was gearing up with emails and talking points to all of us last week.  I’m sure they’re not the only ones.  All of the constituencies (e.g., AHA, AARP, the Tea Party, the Coffee Party, etc.) will be lined up to lobby their delegation during the recess.  So much for a leisurely Easter back home.  Expect quick results on the “doc fix” upon the return of Members following the Easter Recess and ongoing consideration of the changes to the nuances we are all evaluating on the very high level synopsis of 2000+ pages noted above.

Kevin Fickenscher, MD

The views and opinions expressed herein are my own and do not necessarily represent the views and opinions of Dell Services or its affiliates.