CMS suspends doctor-reimbursement cuts used to calculate ObamaCare
posted at 12:55 pm on March 30, 2010 by Ed Morrissey
Democrats pushed the CBO to score their ObamaCare plan without considering a parallel effort called a “doctor fix” that would rescind already-scheduled cuts in Medicare reimbursements to providers. The CBO wound up scoring the bill both ways, thanks to a request by Rep. Paul Ryan (R-WI), and confirmed that the removal of the 21% cuts in reimbursements would make ObamaCare a deficit expander, running hundreds of billions of dollars in the red. Now we don’t have to wait for the Democrats in Congress to pay off the AMA for its support of ObamaCare, as the Centers for Medicare and Medicaid Services have temporarily suspended the cuts in anticipation of the “doc fix”:
Doctors slated to have their Medicare reimbursements cut 21 percent on April 1 got a reprieve from the Centers for Medicare and Medicaid Services, which is delaying lowered payments until after Congress reconvenes.
The agency, which administers the U.S. health program for people 65 years and older and the disabled, has ordered that claims submitted on or after April 1 be held for an added 10 days before being paid, said spokesman Peter Ashkenaz. That’s on top of the 14 days the Baltimore-based CMS usually holds claims. …
Unless Congress postpones or scraps the cuts, the average reimbursement for a colonoscopy would fall to $294.57, compared with the current national rate of $374.20, said Ellen Griffith, a CMS spokeswoman. For a typical visit to the doctor’s office, the reimbursement would fall to $51.70 from $65.67 for an established patient, she said.
The problem with the price-fixing scheme is that it’s narrowing the list of providers. Doctors can’t pay for their own costs now, and cutting reimbursements by 21% will only make the situation worse. It will force more providers out of the Medicare/Medicaid markets, the latter of which Congress expanded to include millions of new clients, which actually makes the situation worse for providers who want to remain part of the Medicaid system. The flood of new patients will displace those covered by private insurance, which will force them to go out of business or get out of Medicaid.
Of course, we knew that before Congress began to debate ObamaCare — and so did the Democrats. The AMA agreed to support their efforts only if Democrats rescinded those cuts. Instead of recalibrating the bill using honest accounting, they claimed deficit reductions that only exist without the doctor fix. For months, Democrats kept the rescission parallel to the overhaul of the health-care system to maintain the illusion of fiscal responsibility.
On April 1st, the illusion ends. When those cuts don’t go into effect, ObamaCare becomes a deficit-expanding program — and that’s assuming that the rest of it works as advertised, a very large assumption that flies in the face of experience from every government entitlement program ever created.