The HCR no one is talking about....

Starting tomorrow, if you are in the hospital and need the help and care of a specialist with extra years of training, he will no longer be able to bill medicare for a consult. He will be able to crosswalk you as a new admission...but only once every 3 years. If you are a 65 year old with leukemia who is admitted more than once for an infection (for example) the specialist will be able to bill almost nothing for their services. A surgeon removing a skin tag (in 30 seconds) can bill 4 times the amount that a specialist can bill for 30 minutes of an exam and later a thorough review of your chart to understand and treat a more complicated problem.

This change has silently been ushered in during the debate on HCR and the back slapping over not having the 21.2% medicare cuts.

What will this mean for patients and doctors alike?

I have yet to talk to a doctor who would outright refuse to see a medicare patient. Most of the people that I know who went into the medical field are genuinely compassionate people who go above and beyond the call of duty regularly... but let's face it...if someone told you that you were going to be earning 20-30% less for the same work at your job AND your taxes were going to go up, would you lose motivation to work as hard or as efficiently?

I am not sure how it happened that doctors became vilified for the hard work that they do day in and day out. It's too bad that we as a nation are choosing to take our frustration with healthcare costs out on the very people who have worked so hard for so many years to help others.

Is it somewhere on the medicare site? It sounds like it might be a misinterpretation/exaggeration. If not I'm probably screwed.

Not my BC/BS. It's called 'cosmetic' -- even in my case where it was one that interfered with function: chafed while walking, making walking painful. They still rejected my appeal.

I come from a field where some people command extremely high fees. But almost all of those people will also work, just as hard and efficiently, for far, far less if circumstances warrant, and the fact is they give away tons of time, outright, as well as simply not expecting golden rates from less than golden sources.
So doctors who think their rates are exclusively about themselves, I really don't get that. I find the mindset to be revolting, actually, out of high end earners. Sickening would be a good word for it.

I missed that.

http://www.healthcapital.com/hcc/newsletter/12_09/Reimbursement.pdf

refer to the consultation code section.

There was a rider to the senate HCR bill that would have stopped this.
It was removed.

There was a victory in the removal of the 21.2%
across the board cuts though.

This will have major ramifications.

On top of that I know that in the past Medicare has left it to hospitals to try and convince police doctors. What I mean by that the Medicare would pay the hospital a fixed amount based on the diagnosis. The doctors, on the other hand, were free to bill for as many in hospital visits as they want. So MDs had a financial incentive to keep patients in as long as possible while it was up to the hospitals to pressure them to reduce the length of stay. In the end many good community hospitals, but who were too small to have the needed influence on physicians, went out of business.

You are so wrong. The hospital is pressuring my husbsndvto codecs certainbway do that THEY don't lose money. Dr's employed by hospitalscare only paid s percentage ofvwhat is billedcand collected. The hospital actually takes quite a bit.

You don't know what you are talking about.

It is separate from HCR. The stoppage of the 21)% across the board Medicare cut was added into tgevSebate bill
but stopping thiscwas cut.

Do dr's do ok? Considering the years of costly education, training and payments for medicsl malpractice, many are not doing well at all.

How many of you have 150,000$ in student loan debt and are expected to work 24/7 purely out of a sense of philanthropy despite the risks of being sued over every green fart someone makes? Are you called in
regularly to work. Even if it is your day off and your child's birthday?

My dh recently saw a 15!year old boy with a bone infection. He recommended hospitalization, iv antibiotics etc. The dad refused because he wanted to take his son HUNTING over the weekend. During that w/e the child fell and broke the infected bone. Result? Sue the hospital and doc.

I guess being stupid pays. In the meantime i didnt notice that HCR includes tort reform. Did you?