March 1997 AAOS Report

Board approves program to oppose Medicare reductions

The Academy's Board of Directors, meeting Feb. 11 in San Francisco, approved unanimously a $234,840 two-phase initiative to attempt to prevent the Health Care Financing Administration (HCFA) from implementing a proposed resource-based practice expense system that could reduce Medicare payments to orthopaedic surgeons by as much as 16 percent, starting Jan. 1, 1998. Michael H. Graham, MD, chairman of the Council on Health Policy and Practice, told the Board that as many as 10 other specialty organizations may join the fight, raising up to $2 million to challenge the proposal.

On Jan. 22, HCFA released four possible options for calculating the resource-based practice expense which represents 45 percent of a physician's payment. If any of the four options are implemented, orthopaedic surgeons can expect an overall reduction in their Medicare reimbursement of between 9 and 16 percent for all orthopaedic services, with the greatest cuts in the surgical codes. Other specialties could experience even more drastic cuts. Payment for cardiac surgery could be decreased by up to 44 percent; thoracic surgery, 40 percent; and neurosurgery, up to 30 percent. Chiropractors could receive an increase of as much as 54 percent; podiatrists, 41 percent; and optometrists, 40 percent. Family practice could receive an increase of as much as 19 percent and internal medicine, 4 percent.

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