Procedure-oriented specialty groups are laying aside their differences with primary care groups in regard to Medicare payments and uniting with them in opposition to a 5.4% cut in Medicare reimbursements.
The proceduralist groups, representing many surgical and internal medicine specialties, in February decided to drop a federal suit against the Centers for Medicare and Medicaid Services that pitted them against primary care providers.
That lawsuit, which tried to change the methodology for calculating practice expense relative value units, had lost on appeal in U.S. District Court in Chicago on Jan. 28. Under the practice expense methodology phased in during the past four years, proceduralists have lost hundreds of millions of dollars a year in reimbursements to primary care physicians, whose groups supported the change.
But the 5.4% cut has "united the medical community," says Michael Roberts, the American Gastroenterological Association's vice president of governmental affairs.
Proceduralist groups have formed the Coalition for Fair Medicare Payment, which is backing a congressional bill to reduce the cut to 0.9%. The bill, sponsored by the AMA last year, will be reintroduced in early March, Roberts says.
Roberts and David Lovett, director of governmental affairs at the American Academy of Orthopaedic Surgeons, say the AMA needs their help.
They allege the bill failed to come to a vote last year mainly because House Republican leaders disagreed with the AMA on its patient protection bill.
But most proceduralist groups didn't support the AMA patient protection bill, and that gives them clout with the Republican leadership in efforts to change the payment update, both men say. The coalition already has met with President Bush, they add.
The Bush administration says it will consider the matter, even though the bill's full proposed change would cost Medicare $120 billion over the next 10 years.
CMS Director Tom Scully adds that another goal for doctors--rescinding this year's cut midway--is unlikely.
Proceduralist groups have not entirely given up on changing the practice expense methodology, despite defeat in the courts. "We can always go back to the legislative arena," Lovett says.