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01/09/2025
RESPONSES/COMMENTS (MEDICARE)
RE: Medicare and Sequestration
From: Jeffrey Kass, DPM
We are still in sequestration. To my knowledge, this will continue through 2032. This Medicare sequestration is essentially a backstop because lawmakers could not reach an agreement on how to meet the maximum deficit amount for each fiscal year. If doctors have to incur the pain of their salary being reduced year after year, how do these lawmakers give themselves raises? And why aren't they mandated to share in the 2% reductions in their salaries? After all, they are the ones who can't balance the budget, not the doctors.
Jeffrey Kass, DPM, Forest Hills, NY
Other messages in this thread:
01/13/2025
RESPONSES/COMMENTS (MEDICARE)
From: Elliot Udell, DPM
When Medicare and other insurance companies begin to cut fees paid to physicians, we might feel the pain, but the ones most adversely affected are our patients. Remember, we are not only doctors but also patients.
Except for the subset of the patient population that are also caregivers, the average "Tom, Dick or Harry" going for medical care might not realize why many physicians are spending less time with them and are often ordering more high-end tests from labs, hospitals, and radiological centers that are affiliated in some way with the hospital or corporation that now employs the physicians.
The more Medicare and other insurance companies continue to cut back, the problem of America providing optimum healthcare to patients will be less and less.
Elliot Udell, DPM, Hicksville, NY
01/11/2025
RESPONSES/COMMENTS (MEDICARE)
From: Judd Davis, DPM
Dr. Kass, I feel your frustration. Every year, there is talk of the annual Medicare cut in Fee For Service payments to providers, and every year there is this last minute push by AMA, APMA, etc. to avert it. I didn't pay much attention to it this year and assumed it was averted, but it was not. I just compared the 2024 vs. 2025 Medicare fee schedules on the Novitas website, and low and behold all of the CPT codes I searched are paying from 2.2-4.6% less this year than last (a web search reveals it’s an average of a 2.8% cut). This doesn't even include the 2% sequestration. So in 2025, we are taking a 4.2-6.6% pay cut on our Medicare payments thanks to our legislators. Do you think they would take such a cut in their pay, HECK NO! Since most of the commercial payers, Tricare, etc. base their payments off the Medicare fee schedule, it will be across the board, and the CEOs of those companies can laugh all the way to the bank as they continue to increase their premiums, pay doctors less, and increase profit margins.
Rest assured your landlord, suppliers, and employees will not be interested in taking a similar pay cut to help you get by, and will instead expect or demand a yearly increase/raise. The topic of why applicants to podiatry schools are diminishing comes up on this forum regularly. Well, here is one huge reason! Since podiatry is at the bottom of the barrel when it comes to income compared to other medical specialties, why would someone want to invest such time, money, and energy to become a limited scope DPM, with a continually declining revenue/income facing them, compliments of our government? If only we could all go concierge and drop insurance entirely or unionize to change things, but it is not likely to happen.
Judd Davis, DPM, Colorado Springs, CO
12/11/2024
RESPONSES/COMMENTS (MEDICARE)
From: Robert Kornfeld, DPM
Dr. Freireich poignantly points out that "No other profession would put up with this year after year." And he is right. This is the point that I have been trying to get across for decades now. There is no profession that I know of that is as highly regulated and consistently exploited and abused as doctors. Every one of you who participates with insurance year after year, either by running a practice that depends on insurance reimbursements or are employed by PE, where insurance is still the method of reimbursement for the corporation are actually, perhaps unwittingly, feeding the monster.
As long as you "employ" the insurance companies to run things, they will continue to steal from you. And since they know you don't do anything about it, they steal more and more every...
Editor's note: Dr. Kornfeld's extended-length letter can be read here.
12/10/2024
RESPONSES/COMMENTS (MEDICARE)
From: Ron Freireich, DPM
WOW! a 1.8% increase
1.8%-2.6% (current inflation rate) = We still lose
And please don't say it's better than a 2.8% pay cut. Either way, physicians are STILL on the losing end. No other profession would put up with this year after year.
Ron Freireich, DPM, Cleveland, OH
12/09/2024
RESPONSES/COMMENTS (MEDICARE)
RE: URGENT - Contact Your Representative About H.R. 10073
From: Mark Ray, DPM
Tell your Representative to co-sponsor the Medicare Patient Access and Practice Stabilization Act (H.R. 10073)!
"Recently, Reps. Greg Murphy, MD (R-NC) and Jimmy Panetta (D-CA) introduced the "Medicare Patient Access and Practice Stabilization Act" (H.R. 10073). This bipartisan legislation seeks to eliminate the looming 2.8% payment cut and provide a 1.8% payment update in 2025, an actual payment increase equal to one half the Medicare Economic Index (MEI), helping to stabilize physician practices and protecting patients' access to care.
Time is running out – there are precious few legislative days left before the end of the year with Congress expected to conduct a "lame duck" session after the elections. This will be the last opportunity for Congress to pass H.R. 10073 as part of the final year-end package."
Source: Physicians Grassroots Network
Mark Ray, DPM, Ligonier, PA
09/24/2021
RESPONSES/COMMENTS (MEDICARE)
RE: Improper Billing Practices of MCR Advantage Plans
From: Paul Kesselman, DPM
Recently, the OIG conducted an investigation on improper billing practices of MCR Advantage Plans. Being aware of what these companies are doing and how they continue to rip off the taxpayers is something we need to be keenly aware of. These companies can only make a profit if: 1) They don't provide care; 2) They undervalue and underpay our services 3) They engineer a scheme by which to obtain more money from CMS (that's us the taxpayer). They have accomplished all three.
So while it is easy for me as a non-clinical practitioner to pontificate not to do business with them, you can make a difference by making it more difficult for them to deny care (with and w/o your patient as they have a degree of responsibility here as well). Take stock of what you are worth and does it really address your worth? Only you can answer that question.
Also be keenly aware of number 3 and do your best to make it as difficult for the named carriers in this report to use your data (that's right it is your data) correctly. I'm not exactly sure how that can be accomplished, but perhaps it starts by requesting the carrier provide your data back to you, so that you can ensure it is correct. The report can be found here.
Paul Kesselman, DPM, Oceanside, NY
12/31/2013
RESPONSES/COMMENTS (MEDICARE)
RE: Locating One's PECOS Number (Chuck Ross, DPM)
From: Paul Kesselman, DPM
Dr. Ross is likely referring to the NPI Number and password. If you can't find your password, you should call the NPI enumerator 1-800-465-3203 ( NPI Toll-Free) or email customerservice@npienumerator.com.
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