President's Message

BRACE YOURSELVES! The tidal wave is coming!

Your Polk County Medical Society Executive Committee has just returned from its Bi-annual Washington, D. C. Fly-In. We talked with the A.M.A, Senators Harkin and Grassley, and Representative Boswell about pressing medical issues. Of utmost importance to all of us is “The Prescription Drug and Medicare Improvement Act of 2003. If this bill is passed in its present form it contains language that will affect the future of our provisions of care to Medicare patients. The majority of the bill has to do with prescription drug coverage for seniors and, thus far, it appears that the House and Senate are widely separated on how to make this work. More pertinent to us, is a provision in the Bill that contains major cuts in Medicare payments to physician, starting at 4.8 to 5.2% in 2004 and increasing up to 15% over the next three to five years. Presently, Medicare payments are based on the antiquated Sustainable Growth Rate, (SGR) which reduces payments to physicians whenever expenditures for services exceed a set target which is dramatically underestimated. Because of this formula, Medicare payments to physicians are to be reduced significantly over the next several years. The SGR is unworkable, unfair and threatens patient access to medical care.

We continue to be concerned about the regional disparity in Medicare Geographic Practice Indices, (GPCI). As you know, Iowa, even with its very high population of Medicare patients, ranks near the lowest in the country's repayment percentages, an issue that needs to be addressed .Other parts of the House Bill contain a mandated change from CPT 9 to CPT 10, increasing the number of codes used for billing purposes from the present 8,000 to over 170,000, inflicting a significant regulatory and financial burden on physicians offices. Mandatory E Prescribing is also in the Bill. It is untested and would be costly to institute and maintain.
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Two things were very evident to me while in Washington. First, physicians, as a group,
are not liked. Some politicians think we are arrogant, pampered, and already overpaid.
Second, since they never hear from us as individual doctors, and only from our society representatives and lobbyists, politicians assume that we are not unhappy with changes that are occurring. In Washington, as in most political arenas, only the squeaky wheels get the oil and we have never squeaked loudly enough.

It is time for us to stand up and be counted as individuals. We must act now, both
as medical societies at local and state levels but, more importantly, as individual physicians. Each of you needs to contact Senators Grassley and Harkin and Representative Boswell. Ask them to support inclusion of the House passed provision to provide positive Medicare payment updates rather than cuts. Ask them to oppose the House passed Medicare prescription drug bill that would allow CMS to mandate ICD-10 codes in place of the current CPT 9 codes. Ask them to support legislation that continues the present CPT 9 code system for physician services, but allows codes to adjust ICD charges for services and supplies not currently included, and finally, ask them to support uniform standards for electronic prescribing without a federal mandate.

If we do not act now, Congress will pass a bill that is hostile to physicians and to our
patients. More and more physicians are already terminating their care to Medicare patients because of increasing costs and failing reimbursements, making access to medical care a major future problem for our seniors. Private insurance repayments are also ultimately based on the Medicare rate, and one can be assured that those too will be reduced. Call, fax, or Email your Congressmen in Washington today (do not write as letters have to be irradiated and take months to reach Washington). I have included appropriate numbers for your convenience in the Bulletin. We will have only ourselves to blame if we let this Bill, in its present form become law.