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As the year comes to an end,
psychologists and clinical social workers are taking part in a new
holiday tradition: watching to see how Congress deals with the
scheduled 27.4% cut mandated by the Balanced Budget Act in
1997. Every year since the Act was passed, the House and Senate have
come through at the last minute with the “doc fix” that avoids
the reduction under Medicare “Sustainable Growth Rate” language in the
budget law.
The same thing is expected to
happen this year, but professional associations are a little less
confident than they usually are because of the budget tightening
mood in Washington.
A 5% cut for of
psychotherapy services--which Congress has been kicking down the road
annually since 2007--also remains in limbo. (That was first
introduced to help finance a fee increase for primary care docs.)
On top of that, the failure of
the so-called “Super Committee” to identify cuts to the federal budget
means that Medicare providers could be looking at an additional 2%
cut starting January 1, 2013.
So in theory, if you add the
three reductions together, non-MD practitioners could be facing
Medicare cuts of 34.4% over the next 13 months. Is such a thing
really possible?
"[Medicare] third party
administrators have already sent the 2012 fee schedule reflecting
those cuts to providers,” says Katherine Nordal, executive director of
the Practice Directorate at the American Psychological Association (APA).
(That’s a 32.4% cut--the other 2% wouldn’t kick in until 2013.)
“They want to give everybody
a heads up. But we're hoping they'll have to do the same thing as
last year, which was to readjust and supplement the . Our government
relations staff thinks it will be resolved and the 5% cut will be
avoided, too.”
Not
everyone’s so confident. “I’m less
optimistic now than I’ve usually been,” says Laura Groshong, a
lobbyist and director of government relations with the Clinical Social
Work Association (CSWA). “It’s hard to believe that a 34% cut would
be allowed, and I’m hoping we can come up with a way to at least
minimize it. But at this point I have to be realistic and look at
what actually could happen. It’s a very discouraging time.”
As the year ended, leaders were
trying to come up with an agreement on the doc fix. One proposal was
for a two-month temporary pact that would prevent a Medicare cut
until March 1.
A brighter spot in the Medicare
picture for 2012 is the continued reduction in copays, which have
traditionally been 50%. But because of the parity law, a copay of 20%
is being phased in. It will be 40% in 2012, 35% in 2013 and 20% in
2014.
“I think that will make mental
health services much more accessible for older people,” Nordal says.
But Groshong believes any
growth in Medicare mental health services “depends on how many
providers are going to keep seeing Medicare patients. Because if
these cuts go into effect, you’re going to see a lot of people
deciding not to take Medicare.”
Contacts:
1) Laura Groshong, CSWA, Seattle, WA, (206)524-3690, lwgroshong@comcast.net;
2) Katherine Nordal, American Psychological Association, Washington,
DC, (202)336-5913, email: knordal@apa.org.
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