This week, U.S. Rep. Gus Bilirakis, R-Fla., introduced the “Providing Relief and Stability for Medicare Patients Act.”
The bill will “ensure patients continue to have access to office-based specialty care providers who incorporate the use of high-tech medical equipment for in-office procedures, such as interventional radiology, vascular surgery, radiation oncology, venous and lymphatic medicine, nephrology, and urology.”
The congressman’s office offered some of the reasons behind the proposal.
“These specialists have been disproportionately harmed by recent Medicare Physician Fee Schedule changes implemented by the Centers for Medicare and Medicaid Services (CMS). These policies at CMS have resulted in double digit cuts to Medicare reimbursement rates for certain office-based specialty providers. These substantial cuts will negatively impact patient care and future access to these potentially life-saving treatments. Additionally, the reductions could lead to a shifting of procedures from an office-based setting, which is often more accessible and clinically appropriate for many beneficiaries, to hospital outpatient departments and ambulatory surgery centers. Office-based specialty care is a critical service outside of the hospital setting, providing a wide range of services to patients with cancer, end-stage renal disease, peripheral artery disease, fibroids, as well as limb salvage and venous ulcer needs. The office setting also is critical to patient access in rural and underserved areas. To combat these concerns and avoid significant disruptions in patient access, the Providing Relief and Stability for Medicare Patients Act will provide additional dollars in targeted relief for specialist providers who have been most adversely affected by clinical labor cuts. It would also seek reforms by requiring Government Accountability Office (GAO) to submit reports analyzing the impact of provider reimbursement cuts under the Physician Fee Schedule on patient access, health system consolidation, and quality of care. GAO also will provide a list of recommendations for reform that would minimize harm to patients,” Bilirakis’ office noted.
“My primary goal is to ensure all Medicare patients have access to quality care in a setting that maximizes their opportunities for a successful outcome,” said Bilirakis. “Continued year-over-year cuts has taken a toll on many specialty care providers’ ability to participate in the Medicare program and provide care to seniors in need. Further reductions will only serve to accelerate health system consolidation – whereby limiting patient choice and access, exacerbating healthcare inequities and likely leading to long-term increases in overall healthcare costs. We need patient-centered reforms that ensure continued access to quality care for all Americans.”
U.S. Reps. Tony Cárdenas, D-Calif., Danny Davis, D-Ill., and Greg Murphy, R-NC, are co-sponsoring the bill.
“Medicare reimbursement cuts to office-based specialists are forcing offices to close and making access to care even more out of reach for Americans in need,” said Cárdenas. “Having fewer care options forces sick patients towards large, more centralized hospitals where patients can face additional barriers to receiving timely, quality care. I’m proud to join Congressmen Bilirakis, Davis and Murphy in ensuring that patients can continue to get quality medical treatment in their own neighborhoods.”
“As a practicing surgeon of over 30 years, I understand the disastrous impacts that Medicare cuts have on physicians and beneficiaries’ access to services,” said Murphy. “Due to the budget-neutral nature of the physician fee schedule, specialties with high direct costs will see overall decreases in reimbursement with increases in clinical labor wages. This inevitably results in physicians’ offices closing, increased consolidation, and ultimately, Medicare beneficiaries seeking care in a higher-cost setting. Rep. Bilirakis’s bipartisan bill is a targeted solution to ensure beneficiaries have access to the most appropriate site of service.”
The bill was sent to the U.S. House Energy and Commerce and the Ways and Means Committees. So far, there is no companion measure over in the U.S. Senate.
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