Physicians are trying to dissuade Republican congressional leaders from cutting their 1996 Medicare fees in reform bills now working their way through the House and Senate.
Although physician groups were expecting initial fee reductions for high-priced surgical services, the House Republican leadership's plan cuts the 1996 payment base for all services, including lower-priced primary care and other nonsurgical services. The Senate plan cuts all but the other nonsurgical category.
The American Medical Association, which had expressed support for the House Republican leadership plan, now acknowledges that the fee cuts included in both plans present "difficulties" and will try to negotiate higher 1996 fees, spokesman James Stacey said.
The AMA bought a full-page advertisement supporting the House GOP plan in the staunchly conservative two days before the House leadership detailed its proposed 1996 physician fees. The paper is widely read in GOP circles.
The AMA still finds "many, many positive features in the leadership plan" presented by the House, such as regulatory relief, malpractice reform and provider-sponsored Medicare managed-care options, Stacey said. Other physician groups said they will have to calculate how much they are willing to allow fees to fall to win on those other provisions.
Marie Michnich, associate executive vice president of the American College of Cardiology, said the AMA's advertisement and other support has been a tactic to stay at the bargaining table.
"They gambled, and probably partially won and partially lost," she said.
Both plans call for a single base payment rate called a "conversion factor," rather than three separate ones under current law. To establish a fee for caring for Medicare beneficiaries, the conversion factor is multiplied by a number of "value units" assigned to each service.