Article - July 11, 2008 - Conroe Courier

Health officials look for increased Medicare reimbursements

By The Associated Press and Lucretia Fernandez

A bill voiding a 10.6 percent pay cut for doctors treating Medicare patients headed to the White House this week for approval, and some Montgomery County health care providers are happy to see it moving forward.

The 10.6 percent cut went into affect July 1. In response, the Centers for Medicare and Medicaid Services instituted a 10-day hold on claims for physician fee services submitted on or after the first of the month.

Although a billing specialist at a Conroe clinic said a hold is not uncommon, and should not hurt a practice financially, U.S. Rep. Kevin Brady, R-The Woodlands, wrote letters of disapproval to the secretary of Health and the administrator of CMMS, citing local doctors who were upset with the decision. Officials with Sadler Clinic and the Lone Star Family Health Center say the decision to withhold payments puts additional financial stress on doctors.

Carroll Woodard, a billing specialist at Conroe Family Medicine, said a hold on claims for physician fee services has occurred before and usually does not affect a general practice.

“I’ve been here since 1991, and we’ve never been affected by a hold at least since then,” Woodard said. “It doesn’t happen every year, but it has happened in the past. As long as it doesn’t last a few months, we should be fine.”

Brady, however, stated in his letters that “upset local doctors who are already struggling with inadequate reimbursement for Medicare patients” will only face additional hardships with the hold.

Jay Jezierski, outreach director for the Lone Star Family Health Center, said he knows doctors who are considering not seeing any new Medicare patients because of the low reimbursement rate they receive for providing the care. He said he would not give the doctors’ names because the doctors don’t want their existing patients to be concerned that they will provide care.

As a federally qualified health care center, the Lone Star Family Health Center must see any patient who comes to the facility. But if the 10.6 percent pay cut is not voided and a longer than 10-day hold is put in place, it would hurt the center’s bottom line, Jezierski said.

In an e-mailed statement from Cindy Alvarado, spokeswoman for Sadler Clinic, she stated the decision to withhold payments is “placing the country’s physicians in peril.”

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