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Medicare Physician Payment Reform
Since the passage of the Balanced Budget Act of 1997, Medicare reimbursement for physicians has been determined each year according to the sustainable growth rate formula, which links annual Medicare physician payments to the overall economy’s performance. Unfortunately, this payment approach has become severely outdated and inadequate, leading to major financial problems for physicians and access to care challenges for beneficiaries.
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Enhancing Patient Access to Medigap Insurance - Thirty-one states have taken action to extend Medigap access to ESRD and disabled Medicare beneficiaries under age 65. ANC supports these efforts to expand Medigap access and urges the federal government and states to take similar action to help ESRD and disabled patients while improving state budgetary outcomes.
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ANC 2010 Congressional Issues - Summary
Physician Payment Reform - Ensuring continued access to quality kidney care for all patients
Medicare Secondary Payer (MSP) - Improving quality care and fund health reform through an extension of MSP
Immunosuppressive Drug Coverage - Expand Medicare Part B coverage of medications needed to reduce the likelihood of organ rejection amoung kidney transplant recipients
New CMS Physician Fee Schedule Methodology - Scheduled payment cuts negatively impact providers caring for vulnerable populations
Medicare Improvements for Patients and Providers Act (MIPPA)—the passage of MIPPA in 2008 was a victory for the kidney care community. In 2009, ANC and the community must ensure that the gains obtained in MIPPA are not lost and ensure proper implementation of the provisions including CKD IV education benefits.
Medicare Advantage Plans—Currently not all dialysis patients can enroll in Medicare Advantage plans. These plans could provide patients with coordinated care and additional benefits—possibly resulting in reduced hospitalizations.
MediGap—Currently only 31 states allow dialysis patients under 65 years old to obtain a Medigap policy. ANC will work with the community to help obtain Medigap coverage for patients entering Medicare due to ESRD.
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