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Medicare Docs Guess at Paychecks Amid Reimbursement Questions
Wall Street Journal ^ | 4-1-10 | Shirley Wang

Posted on 04/02/2010 2:44:33 PM PDT by STARWISE

It’s no joke for doctors that today marks the day that Medicare’s 21% reimbursement pay cuts were to go into effect.

Congress left for its Easter recess without voting to delay the scheduled April 1 start of lower payments to docs. The agency that oversees Medicare has effectively delayed the cuts by deciding not to pay claims for the first 10 business days in April. When Congress returns, it’s still expected to adopt another law to delay the cuts for longer, as it has done annually for years now.

So what does the delay in paying claims mean for doctors?

In the short-term, their cash flow shouldn’t be disrupted much, according to the Centers for Medicare and Medicaid. Typically claims are paid no sooner than 14 calendar days anyway, so doctors shouldn’t see a dip in their income unless Congress fails to act with a new delay in the next two weeks, the agency says.

But the long-standing threat of Medicare cuts are weighing on doctors, say medical societies.

“It’s tough,” Andrew LaMar, spokesman for the California Medical Association, told the Health Blog. “Imagine if every month you didn’t know what your paycheck is going to be.”

(Excerpt) Read more at blogs.wsj.com ...


TOPICS: Business/Economy; Front Page News; Government; Politics/Elections
KEYWORDS: cuts; deathbyfiat; doctors; medicare; obamacare
"It’s no joke for doctors that today marks the day that Medicare’s 21% reimbursement pay cuts were to go into effect."


1 posted on 04/02/2010 2:44:33 PM PDT by STARWISE
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To: STARWISE
I am a postal worker who's car was hit by a man who ran a yield sign. My dr, hosp, physical therapy, xray, bills are all being paid at 25 - 50 percent. I'm embarrassed. They have denied the er hosp bill twice already because they didn't put a number in the right box. I have to have 3 people's permission to go to a specialist, or have an xray. And the most interesting part is that they will be reimbursed for all charges they have paid by the other guys insurance. If this is what's coming, it is not good.
2 posted on 04/02/2010 2:50:35 PM PDT by grame (May you know more of the love of God Almighty in the coming year)
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To: onyx; penelopesire; seekthetruth; television is just wrong; jcsjcm; BP2; Pablo Mac; ...

...PING!


3 posted on 04/02/2010 2:54:26 PM PDT by STARWISE (The overlords are in place .. we are a nation under siege .. pray, go Galt & hunker down)
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To: grame

Very bad .. an evil wind is blowing.


4 posted on 04/02/2010 2:56:05 PM PDT by STARWISE (The overlords are in place .. we are a nation under siege .. pray, go Galt & hunker down)
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To: STARWISE

There’s a bit of “hate speech” getting ready to flow from my keyboard...

$*%^&#$ ^(*$#@* gov#$%^$nt!!!!!!!!


5 posted on 04/02/2010 3:00:16 PM PDT by SE Mom (Proud mom of an Iraq war combat vet)
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To: STARWISE

“It’s tough,” Andrew LaMar, spokesman for the California Medical Association, told the Health Blog. “Imagine if every month you didn’t know what your paycheck is going to be.”

Well, being self-employed, I deal with that all the time! Or, for the unemployed - they would be happy with any paycheck.

I think a better statement would have been “Imagine if every month you didn’t know what the government would declare your wage to be?” (Didn’t FDR do that for every single industry and service?)


6 posted on 04/02/2010 3:11:02 PM PDT by 21twelve ( UNINTENDED CONSEQUENCES MY ARSE: "..now begin the work of remaking America."-Obama, 1/20/09)
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To: STARWISE


7 posted on 04/02/2010 3:11:23 PM PDT by Chode (American Hedonist *DTOM* -ww- NO Pity for the LAZY)
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To: STARWISE

How about the docs give IUO’s to their employees, along with a note that NObama is holding up reimbursements???


8 posted on 04/02/2010 3:11:46 PM PDT by ridesthemiles
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To: STARWISE

EVIL.


9 posted on 04/02/2010 3:11:53 PM PDT by onyx (Facts don't matter. Proof not required. Anything goes! Racial slurs, death threats.....)
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To: onyx

Check out “The Great Reneger” - http://www.youtube.com/watch?v=QdKmc9aBELM


10 posted on 04/02/2010 3:16:43 PM PDT by Free America52 (The White guys are getting pissed off. We beat Hitler Hirohito and Krushchev. Obama will be easy.)
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To: STARWISE

I have a framed payment from medicare for services rendered.
Amount=11cents


11 posted on 04/02/2010 3:20:03 PM PDT by doc maverick
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To: grame

That is what’s coming and it’s not good.

Medicare is the largest Insurance plan around and if, as Barry says, size would result in greater efficiency and buying power, then Medicare would not be the shining example I would point to as a prototype.

They have 50% more denial rates
Their payments to doctors take 60% longer than private insurance.
They have 50% more paperwork involved.
They have a standard of care objective and that is all they provide.
They have less procedure alternatives
They absolutely require an escalation of specialist to specialist to specialist and so on.
2nd and 3rd opinions are not renumerated.

They pay about 50% less than private insurance

And then you have all the losers of life who think everyone owes them. They cry with the Faux indignation that anyone would make a profit off their healthcare.

To which I say “I understand and those are valid issues”

So let me ask you this; who in the supply chain for your care should take less money home every month.

I will let you choose:
The Phone Company that provides Internet access so your records, x-rays, MRI’s, etc can be transferred around the world for convenience and so other specialists can interpret the results?

How about the electric company that lights the doctors office, keeps the factory running that make artificial parts, prosthetics or drugs to give you a quality of life you accept or keep you alive. Heck they even provide power to the operating room with $million$ of Dollar$ in equipment to provide you with care.

Should the company that makes the diagnostic and monitoring machines be forced to take less money for their services or equipment?

Should the company that makes software to run these machines take less money?

Shold the company that makes software that enables your records to always be available take less money.

Should the janitor that keeps the rooms clean and sanitary, in the hospital take less money home?

How about the company that makes alcohol and other antiseptics?

And the company that makes soap to wash your hands and the hands of hospital staff and healthcare providers?

What of the company that makes all that paper? You know the paper towels, tampons, gauge, toilet tissue, charts and records? They just cut less trees this year?

How about water? That’s right, does the water company that flushes away your waste and blood products in a hospital, ambulance or doctors office take less money this year, for you?

How about the company that makes and stores blood, so your envious ass can be provided with a transfusion to keep your blood pressure up, your heart pumping and well.... Keep you alive? Less money?

How about the food service company that keeps the staff, guests and patients feed so there is less reason to go off site and bring it back? I might agree with you here, since I am not sure they actually serve food but, something they call food. Still real people work 8 hours a day making it or whatever it is.

What of the company that makes stents so your blood platlets won’t come off in your artery and go to heart causing an aortic interruption. You know the kind where your heart stops pumping.

The fireman, the policeman, the EMT, the ambulance driver
- Choose; who takes less money this year?

For all the corporation above, I would suggest you look at your choices for who takes less money home this year and who you impoverish because you think no one should make money off your healthcare.

There are real people, with real bills and families working at these “faceless” companies.

Tell me, which family do you damn to an alternative life than the one they lead now and force them into poverty.

Who has to lose their home?

Who has to take a bus everyday?

Who can no longer afford their own healthcare or of their children.

Who do you demand, you selfish, self serving entitled, deluded moron, who do you demand make less to serve you and your utopia that everyone bow, kiss your ring finger and serve you.

Who!?


12 posted on 04/02/2010 3:20:59 PM PDT by Vendome (Don't take life so seriously... You'll never live through it.)
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To: Free America52

At over 4 mnutes, too long for a campaign ad, but it nails the SOB.

Thanks for linking it here.


13 posted on 04/02/2010 3:23:35 PM PDT by onyx (Facts don't matter. Proof not required. Anything goes! Racial slurs, death threats.....)
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To: STARWISE
Let's take the example of something like diabetes, one of, uh, a
disease that's skyrocketing, partly because of obesity, partly
because it's not treated as effectively as it could be. Right now if
we paid a family -- if a family care physician works with his or her
patient to help them lose weight, modify diet, monitors whether
they're taking their medications in a timely fashion, they might
get reimbursed a pittance. But if that same diabetic ends up
getting their foot amputated, that's $30,000, $40,000, $50,000...
immediately the surgeon is reimbursed.--Barack Obama 8/11/2009
One of many blatant Obama lies. In reality, Medicare reimbursement for those evil physicians is $800-$1000, inclusive of all post-op visits for 90 days, before the 21% Medicare decrease.

If you go to a New York ER with a heart attack, NY Medicaid will pay the greedy ER doctor $17.00.

14 posted on 04/02/2010 3:26:57 PM PDT by NautiNurse (ObamaCare uses Bernie Madoff threory of economics)
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To: grame
"I'm embarrassed.

That pretty much sums up the way I feel when my Doctor sees me.

Even before Obama Care passed, I was ever so grateful I could secure an appt. considering what the Doctor was reimbursed. Now this? God help us.

15 posted on 04/02/2010 3:29:46 PM PDT by spectre ( Spectre's wife)
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To: NautiNurse

Just breathtaking tyranny and thuggery
from the overlord. God, help us when
we lose the tens of thousands of doctors,
who worked so hard for those extra 4-8
years to achieve excellence in the fields
we need so badly and that set America apart
as the premier advanced medical community.

Who will care for us?

And who will care for all those entitled
redistributed wealth recipients on whom
-0 wants so much to lavish his love?

Now, more than ever ... we’ll have to be
the savvy keepers of our own health as much
as humanly possible .. and pray.


16 posted on 04/02/2010 3:58:18 PM PDT by STARWISE (The overlords are in place .. we are a nation under siege .. pray, go Galt & hunker down)
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To: 21twelve

Not every profession has to pay the outrageous malpractice insurance rates that docs do.


17 posted on 04/02/2010 4:14:50 PM PDT by mimaw
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To: grame

It’s what is coming. I’m on Medicare part B and Tricare For Life, the retired over 65 Military’s secondary health ins. I had to jump through several hoops, including putting my Senator on their tails to get permission to have the name brand Synthroid to treat my under active thyroid, instead of the generic form...makes ulcers in my mouth (I wear a partial plate) and your hair to fall out. The generic is not absorbed as well by your body, you have to be tested 3-4 times a year to make sure if it is working. Where on the name brand you only need testing 2 times a year. There is only a few cents difference in the drugs pricing. The extra testing eats up any cost savings.


18 posted on 04/02/2010 4:24:15 PM PDT by GailA (obamacare paid for by cuts & taxes on most vulnerable Veterans, retired Military, disabled & Seniors)
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To: AdmSmith; Berosus; bigheadfred; Convert from ECUSA; dervish; Ernest_at_the_Beach; Fred Nerks; ...
Yesterday...
...Medicare's 21% reimbursement pay cuts were to go into effect. Congress left for its Easter recess without voting to delay the scheduled April 1 start of lower payments to docs.

19 posted on 04/02/2010 4:41:28 PM PDT by SunkenCiv ("Fools learn from experience. I prefer to learn from the experience of others." -- Otto von Bismarck)
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To: STARWISE

A lot of doctors and pharmacies are going to try and drop Medicare but the new healthcare law forces states to try and stop that from happening.


20 posted on 04/02/2010 4:41:47 PM PDT by GeronL (There is only a "Happily ever after" for you if you're the one writing your own script)
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To: Vendome
The interesting thing about all this percentage payment of the bills, there doesn't seem to be any system, or pattern. I chose to go to my reg doc instead of the work comp dr, and they are paying him 100%. I was going to pay the difference if they didn't. I wouldn't be able to go back. With the headaches they have caused the girls in the office.
21 posted on 04/02/2010 4:52:19 PM PDT by grame (May you know more of the love of God Almighty in the coming year)
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To: grame

I have two friends on Medicare and their experiences are different everytime.


22 posted on 04/02/2010 4:54:07 PM PDT by Vendome (Don't take life so seriously... You'll never live through it.)
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To: GailA
I hear ya on that one. The drug store changed mine one time because they weren't going to buy from that company anymore, and my system went crazy. It's not nice to mess with a woman's thyroid.
I try to abide by all the rules, don't take with caffeine, take 1 hr before you eat, take the same time every day, and then they just oops we're changing you to something different.
I have enough trouble keeping my temps above 97 as it is. Gov’t might decide we all need generic. or the drug companies will all move to other countries and we won't have any quality controls on what we get.
23 posted on 04/02/2010 4:57:02 PM PDT by grame (May you know more of the love of God Almighty in the coming year)
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To: grame

Both my husband and I am also embarrassed to go to our drs. He has Parkinson’s, and an unusual adrenal problem (hyperaldosteronism). Both the nephrologist and his neurologist are so kind to him.

The neurologist, particularly, spends so much time with him when he gets checked every 8 weeks.

We hate what Medicare is doing to these docs, and we want to figure out some way to compensate them for what they are not being paid.


24 posted on 04/02/2010 6:45:51 PM PDT by jacquej
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To: jacquej

We have not been able to make our pay roll to physician on time the last 2 1/2 months. Plus my pay check is down 30%. If this keeps up I am going to have to moonlight in additon to my full time FP practice to pay my bills. I have been in practice for 17 years and this has NEVER happened. I think we are going to lay off at least 5 people this month. We can not keep this up. We actually had to borrow money to make pay roll in February.


25 posted on 04/02/2010 6:54:12 PM PDT by therut
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To: therut

and, please tell me if I am wrong here. We are not permitted to make an additional payment when we visit you for a check-up.

We are far from wealthy, with only a little saved, and hoping that social security and our children will fill in the gaps when the savings are gone.

BUT! We do not want our doctors to be punished because we are forced onto Medicare, and we absolutely believe that a doctor is providing a valuable service, and he deserves to be paid in full for the cost of our visit.

As it stands now, we are not allowed to pay anything to a doctor in cash to compensate him for his time, talent, and wisdom. I am wondering if I could offer beautifully hand-kint Aran sweaters if money can’t be taken.

Or, perhaps, a nice collectible coin for the start of a new hobby?

What would work? Do you have any ideas?


26 posted on 04/02/2010 7:01:37 PM PDT by jacquej
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To: jacquej

Call the .gov and ask them to increase payments. Or my idea is give physicians a tax break for taking care of .gov patients. I am afraid nothing is going to be done. I might add I have a full practice and take care of hospital and nursing home patients. I see 40 patients a day ( which is hard) and it seems like we are drowning and not even treading water anymore.


27 posted on 04/02/2010 8:00:03 PM PDT by therut
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To: mimaw

“Not every profession has to pay the outrageous malpractice insurance rates that docs do.”

Or pay for years of med school, etc. I in no way am bashing the doctor. Just that ALL of us need to be fighting this crap ALL the time. Obama, just like all Commies, is turning this into class warfare. The “rich” against the poor.

There was a thread about companies keeping lots of money in reserve due to fears of worse days ahead. Even some Freepers were saying “they shouldn’t have that money stashed away, they could be hiring people with that money”. And it will get worse before it gets better.


28 posted on 04/02/2010 10:37:42 PM PDT by 21twelve ( UNINTENDED CONSEQUENCES MY ARSE: "..now begin the work of remaking America."-Obama, 1/20/09)
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To: jacquej

I think any gesture would be nice. Talk to the doc about it. Years ago I had an operation and thought the price was high, and asked my doc about it. He said “don’t let anyone tell you we don’t have socialized medicine already”. This was about the time of HillaryCare. He said in order to make up for those on medicare and for poor folks that just didn’t pay, he had to charge those that could pay and/or that had insurance more to make up the difference. (He thought my $4,000 operation should really be about $2500).

Of course that was years ago. I think things have gotten harder for the docs over the past several years, and it will be terrible for them (and us!) in the near future.


29 posted on 04/02/2010 10:44:00 PM PDT by 21twelve ( UNINTENDED CONSEQUENCES MY ARSE: "..now begin the work of remaking America."-Obama, 1/20/09)
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To: grame

They’ve not done it with my Synthroid because I’ve been paying for it myself. I’m cleared to have TFL start paying their portion starting this month. We will have to fight to get them to cover the past 18 months. But they have changed my water pill on me, thankfully no difference. I too worry about any drugs made in third world countries, especially CHINA. Canada is ok, but that is as far as I’m willing to trust to imported meds.

I’m one of those ‘hard to treat’ patients because I react badly to so many different meds. My arthritis doc threw up his hands and said he could do anything for me. I have Osteo A in both hands, Osteo Porois in right hand, OA in 5 disc, and both feet from broken toes. To add insult to injury I have Fibromyalgia to boot. NEVER take Lyrica if you have arthritis, it attacks the joints and the pain is unbearable.

It also worries me that some doc don’t take the time to READ your med sheet they make you fill out, and then proceed to give you one of those drugs you react to. I have a sheet I print out and hand to them of what I take and what I react badly to. Saves time, hand pain, and you don’t forget something. If they don’t read it and call the drug by another name, you don’t know the difference and then you end up having a bad reaction that puts you out of commission for several days.


30 posted on 04/03/2010 6:52:19 AM PDT by GailA (obamacare paid for by cuts & taxes on most vulnerable Veterans, retired Military, disabled & Seniors)
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To: GailA
My best advocate is myself. You are right about watching your own meds too. I have to know how stuff affects me and keep track. I have the arthritis(my dad had it bad) and I'm a mailman and they say that accelerates the degeneration by about 10 years or so. I take Mobic now, darvacet, and a cortisone shot every six months, but I'm about to move to the quarterly on that. I need to work 2 more years and cortisone is probably gonna help my body get there.

I'm very sensitive to most everything so I can start on 1/2 to 1/4 of the normal dose. My husband is the opposite. Many times the normal doesn't even register in his system. My concern is changing drs. I don't do that well, and the one I have now we have a good understanding of each other. That's a good thing most of the time. I'm trusting the Lord to guide me.

I did tone down some of my arthritis flare ups by cutting out acids, oj, tomato juice, less tomato soup, red meat(I still have some but not all the time.) I got shingles and had a bad flare with the arthritis that lasted about 8 or 10 weeks at least. Couldn't even knock on a door. but we're good now. Cortisone quarterly probably helps!

31 posted on 04/03/2010 11:41:25 AM PDT by grame (May you know more of the love of God Almighty in the coming year)
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To: grame

And Celestone causes the worst side effects for me, besides Lyrica. ALL arthritis drugs tear up my gastro intestinal tract, there is not enough Nexium to stop the acid reflux, never mind the bowel/bladder spasms, intestinal gas bubbles chronic constipation that they cause.

I found that 5 mg Valium with 1 eight hr tylenol lets me sleep at night for at least 5 hrs. Along with a trip to the hot tub for 15 mins. Which lowers my pain level. Diet doesn’t seem to make a difference for me.

Do what works. My husband has OA in his shoulders keeps him in constant pain, in places you usually don’t get it, he’s a retired Senior Chief, retired teacher. He had a partial knee replacement last June, and that OA pain is gone. recovery was swift never even used a cane, PT done at home. The doctor who does this procedure has patients come from as far away as Missouri, one even came from Minnesota all the way to Memphis, TN. He’s that good.

IF it gets to bad apply for disability, I had to. I was widowed at the time and couldn’t even support myself. But if you go that route, get a lawyer on the front end. They always turn you down the first time if you don’t. Having the lawyer on the front end helps. (learned that the hard way)


32 posted on 04/03/2010 12:09:40 PM PDT by GailA (obamacare paid for by cuts & taxes on most vulnerable Veterans, retired Military, disabled & Seniors)
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To: GailA
I have used aciphex for my stomach and it was night and day different than nexium and 1000 % more effective with no side effects.
33 posted on 04/03/2010 2:18:29 PM PDT by grame (May you know more of the love of God Almighty in the coming year)
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To: grame

Tried it, didn’t work for me, Nexium handles it nicely as long as I stay off the arthur meds! I’ve also added 1 acidopholis (sp?) gold to my vit/mineral regime. Less calories than Activia. I get them from Walgreens or Krogers when they put them on sale buy 1 get 1 free and usually have a Nature’s Bounty coupon to boot.


34 posted on 04/03/2010 5:05:07 PM PDT by GailA (obamacare paid for by cuts & taxes on most vulnerable Veterans, retired Military, disabled & Seniors)
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To: NautiNurse

Obama is such a liar. It’s the government that decided that the family practice physician gets a mere pittance and those physicians who perform procedures get reimbursed at a higher rate. The insurance companies followed.

I have friends who don’t even send bills to Medicaid. It cost them more to send a bill. They just perform all those services gratis.


35 posted on 04/03/2010 5:14:02 PM PDT by ladyjane
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