UPDATE: It seems, now, that Walgreens is facing financial disaster too if they accept more Medicare patients.
Remember, I said no Medicare payments had been made since October first because the guidelines hadn’t been published in the Federal Register yet? This is why Walgreens won’t accept new Medicare patients after April 16th.
~~Original Post Below:~~
You may remember from last year’s Healthcare Debates that President Obama proposed around $500 Billion in cuts to Medicare to achieve savings to fund ObamaCare.
You may not know that these cuts were, in fact, carried out in the new fiscal year budget, even though ObamaCare hasn’t passed.
It is a federal requirement for new federal legislation that every new law have it’s provisions printed in the Federal Register, so that the people who will be affected by these new regulations can see them in black and white, as well as have spelled out for them what they need to do to be in compliance with this law. To date, the Obama Administration has not printed the rules to enacting these Medicare cuts in the Federal Register — or, for that matter, anywhere else.
Which is either complete incompetence or utter stupidity on their part; if not utter contempt of how the rules work in Washington. Take your pick.
And don’t think that the companies involved in the 17% of the GDP that is the American Healthcare system aren’t beginning to panic. I’ve received several confidential messages from physicians in the San Antonio area that all confirm that this is no small earthquake about to break on the medical scene. Consider:
- All users of motorized electric wheelchairs — Scooters, Rascals, what-have-you — that purchased them through Medicare and Medicaid received a written notice last November that Medicare would no longer be funding these items in fiscal 2010.
- Small practitioners are especially feeling the pinch. One orthopedic specialist told me today, “If this Health Care thing goes through, I’ll have to choose between paying my staff minimum wage or buying them all Health care – and since the government won’t allow one or the other, I will probably have to quit my practice and fire my staff.
- As a result, the American Medical Association, which has heavily supported Obama’s Health Care nightmare, has seen it’s ranks dwindle dramatically. At the beginning of 2009 the AMA only had approximately 10% of the physicians in the U.S. as members; today it has less than 3%.
A word of explanation on the next part first: Medicare pays on the Fiscal Quarters system. All the charges for one fiscal quarter are submitted during the second fiscal quarter, and then paid at the start of the third fiscal quarter. This means (theoretically, of course; individual cases may vary) that a patient who saw their doctor on October 1st (the first day of the Fiscal quarter) would have their claim submitted to Medicare on January 1st (the first day of the second fiscal quarter), and the doctor will get paid on April 1st (the first day of the third fiscal quarter.)
In short, the federal government hides behind Red Tape to put off processing and paying Medicare claims for 90 days at a time; resulting in up to six months backlog at a time.
And April first is coming in three weeks, and with the Federal Register still not having published the new Medicare guidelines, that’s five-going-on-six months of claims still waiting to be processed and paid . . . .
Which resulted in these two interesting tips:
- One of the largest Medical Research facilities in San Antonio (if the the world) which only in the past few years built a new office complex and research lab on Medical Drive in the Medical Center north complex, held an emergency staff meeting this past week. All nine staff physicians (and ten plus research physicians) were told research grants — their life blood – had been slashed, and no new medical research grants would be paid this fiscal year. They are not even sure if their existing grants will be paid through completion. As a result, no new research will be performed until Medicare clarifies when (if ever) they will again give research grants in diabetes or glandular medicine.
They are preparing lists of staff who will be terminated if the cuts become permanent.
San Antonio is also home to two of the largest Dialysis chains in the world. With a population of over 60,000 End Stage Renal Disease (ESRD) patients, San Antonio is ground zero for Dialysis and transplantation of kidneys.
This past weekend the largest of these groups – and one of the oldest groups of nephrologists (kidney doctors) in the U.S., also held an emergency staff meeting. These physicians — who work for a basic wage and earn bonuses at the end of the year based on productivity — were told that because of the Medicare cuts this year that:
- There will be NO bonuses this year whatsoever;
- The group is facing a shortfall due to the cuts that is conservatively estimated at $3.6 Million — and dropping bonuses will only cover about HALF this amount, if not less;
- Everyone at the group — including physicians and management — will be facing a pay cut of about 50%,effective April 1st.
Fortunately, no staff cuts at this San Antonio Kidney Disease group . . . yet. But you have to wonder how many nurses, medical assistants, doctors, and other healthcare workers will stay at a group where they’re being paid less than a living wage.
And if the largest Kidney Disease group in the world can’t make it on these Medicare cuts . . . how can the smaller groups?
And if these groups close, along with their attendant Dialysis Clinics, that leaves 60,000 people without the treatment they need to live.
Watch for President Doomsayer to (a) blame this on Bush, and (b) proclaim that “only Heathcare Reform can save them now!”
Impacting soon at a hospital or clinic near you.