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that drive utilization of health care services. This means the board will have only one option — cut payments. And through 2019, hospitals, Medicare Advantage plans, Medicare prescription drug plans, and health care professionals other than physicians are exempt.98


have only one option — cut Medicare payments to physicians. Cuts the board recommends will automatically take effect, unless Congress acts to suspend them.


As we’ve seen with the SGR, it’s obvious that cuts the IPAB enacts will devastate Medicare beneficiaries’ ability to find physicians to care for them. The issue of Medicare spending for 3.8 million Texans is too important to be left in the hands of an unaccountable board that makes decisions based solely on cost.


Allow Medicare beneficiaries to contract directly with physicians for care


Growing bureaucratic burdens, inadequate payment rates that haven’t kept pace with the rising costs of providing care, annual threats of pay cuts, and full patient schedules combine to make it increasingly difficult for physicians to continue


seeing Medicare patients. While most will keep their longtime patients after they become eligible for Medicare, a growing number of physicians already have been forced to stop seeing new Medicare patients.


This means the board will


Currently, seniors who want to see a doctor who will not accept their Medicare insurance must pay for their care entirely out of their own pocket. As baby boomers come of Medicare age, we will need to change some of Medicare’s inflexible rules to ensure patients have access to a physician. One way to accomplish this is to allow Medicare patients to see any physician of their choice. Physicians should be allowed to enter into direct contracts with Medicare patients, even when they opt out of Medicare.


The Medicare Patient Empowerment Act would allow seniors to use their current Medicare coverage to see a doctor who is not accepting Medicare. It would strengthen patient choice and access to physicians. It would ensure that seniors can see any doctor they choose and still use the Medicare benefits for which they have paid, without having to change their Medicare plan.


Comparative Fee Updates for Medicare Providers Percent Change From 2001


150% 140% 130% 120% 110% 100% 90% 80% 70% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 U.S. Department of Labor; Centers for Medicare & Medicaid Services, 2012


Almost 30-percent cut 62 TEXAS MEDICINE January 2013


— Hospital Inpatient and Outpatient


— Skilled Nursing Facility


— Home Health Agency


— MEI — Physician Practice Costs


— Physician


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