January 2012

Searching For Solutions To The Ongoing Threat Of Medicare Reimbursement Cuts

By Brian McCurdy, Senior Editor

Although Congress acted last month to prevent a 27 percent reimbursement cut for Medicare, questions remain as to ensuring long-term reimbursement stability for podiatric physicians. The House passed HR 3630, which would increase Medicare physician payments by 1 percent each in 2012 and 2013.

   Anthony Poggio, DPM, cites an inherent problem with the Sustainable Growth Rate (SGR) formula that drives Medicare reimbursements. He feels the formula’s accounting principles do not translate well to the real world.

   “No business entity could sustain at 20 percent-plus cut in reimbursement and expect to survive,” maintains Dr. Poggio, a member of the American College of Podiatric Medical Reviewers.

   As Lee C. Rogers, DPM, notes, the Medicare Payment Advisory Commission (MedPAC) voted in October to repeal the SGR and replace it with a 5.9 percent reimbursement cut for specialists each year for three years. Dr. Rogers says this would be followed by a seven-year freeze on reimbursement for specialists. Accompanying the reimbursement changes for specialists would be a 10-year reimbursement freeze for primary care providers, according to Dr. Rogers.

   “This is not a viable option as many specialists have threatened to leave the program,” says Dr. Rogers, the Co-Director of the Amputation Prevention Center at Valley Presbyterian Hospital in Los Angeles. “The option which is most fair — and one I would support — replaces the SGR with a yearly adjustment based on inflation and ensures it is properly funded.”

   If a 27 percent reimbursement cut actually happened, Dr. Poggio says there would have been “a huge exodus of Medicare providers” as well as “tremendous pressure” from senior citizen advocates to prevent the cuts. He suggests correcting or disbanding the SGR formula altogether, and using common sense to address this issue.

   “That requires some political backbone on the part on Congress,” adds Dr. Poggio. “Without some Congressional will to address healthcare as a whole, I think we will continue to kick the can down the road and create temporary fixes every year.”

   However, Dr. Rogers notes that the yearly threat of Medicare reimbursement cuts “actually benefits Congress because it fills campaign coffers with donations from doctors around the country trying to stave off drastic cuts in reimbursement. If there was a permanent solution or if it did not become urgent, the money would not flow as easily to Congress.”

   Dr. Rogers, who is running for Congress in California this year, notes that the physician fee schedule for 2012 includes “drastic reductions” for podiatrists who use skin substitutes in the clinic or operating room. He does not predict any meaningful congressional action on Medicare in the foreseeable future.

   “Partisanship is as high as it has ever been and each side is posturing ahead of a bitter campaign season with congressional approval ratings tied for the lowest in history,” says Dr. Rogers.

Podiatry Today Poll: Most DPMs Use Taping in Practice

By Danielle Chicano

A large majority of podiatrists who responded to a recent Podiatry Today online poll say they use taping as part of their treatment armamentarium (see http://bit.ly/ukxGfY ). Out of 378 respondents, 83 percent (315 people) answered “yes” while the remaining 17 percent (63 people) stated they do not use taping in their practice.

   Among those who responded “yes” is Frank Kase, DPM, a Past President of the California Podiatric Medical Association.

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