Medicare’s Discriminatory Podiatry Pay Cut

by | Aug 31, 2018 | complicated, doctor, elderly, medical, Medicare, patient, Pay-cut, physician, podiatrist, podiatry, wound care | 0 comments


Be prepared to lose your podiatrist!
Why?

This proposed approach to reducing paperwork would have unintended consequences for Medicare beneficiaries. To offset the reimbursement cut, some physicians may spend less time with their patients and limit each office visit to one or two problems forcing patients to return for a second additional visit to address additional medical issues. This will also reduce the quality of care, particularly for patients with complex medical conditions.

Deadline to complain is Sept 9, 2018.


The proposals to consolidate the billing codes for physician evaluation and management so as to pay the same amount for office visits, regardless of the complexity of the patient, would cut payments for visits that are currently reimbursed at higher levels than simple or routine office visits, penalizing doctors who treat sicker patients or patients with multiple conditions. For a podiatric physician/surgeon the reimbursement would be $16 for an established patient and about $24 for a new patient. 

Medicare doesn’t understand that this middle toe fracture patient who hurts but cannot be safely given an anti-inflammatory because they have hypertension, chronic NSAID use, polycystic kidney disease, Stage 2 renal disease, need X-rays, and requires MORE THAN a $16 Evaluate & Manage. We will refer these patients to the ER or Ortho, where they can spend the needed time with the patient.

TELL THEM NO! MEDICARE ON-LINE COMPLAINT FORM
WRITE MEDICARE AND SAY NO to the proposed discriminatory pay reduction to podiatry

And this patient:
Medicare doesn’t understand that THIS ingrown nail was attached to a diabetic, renal disease, AFIB, anticoagulation medication, peripheral vascular disease patient with multiple drug allergies and a multidrug-resistant infection.

Starting Jan 2019, they would have to go to their PCP, Ortho, General Surgeon, or ER.

Our office, and many throughout the Nation, will not be able to see and manage these patients for $16.   This proposed approach to reducing paperwork would have unintended consequences for Medicare beneficiaries. To offset the reimbursement cut, some physicians may spend less time with their patients and limit each office visit to one or two problems forcing patients to return for a second additional visit to address additional medical issues.



This will also reduce the quality of care, particularly for patients with complex medical conditions.


Here is another example:  This patient, whose dog jumped up on their lap causing a tearing their skin, would be sent to the ER (or to their PCP – if they had an opening) due to the list of comorbidities we will manage. The examination, cleaning & dressing wound, establishment of home health care, infection control, and wound care plan is devalued by this Medicare proposal.


Skin Tear – Pet scratch complication
Dermatoporosis – Systemic corticosteroid complication

Rheumatoid arthritis

Pulmonary fibrosis
Impaired wound healing,
Osteoporosis
Steroid myopathy
Hyperlipidemia
Chromoblastomycosis

You have till September 9th to TELL THEM NO! 


So do it, act now before you lose. 

Who do you write?
The Honorable Seema Verma 
Administrator 
Centers for Medicare & Medicaid Services 
U.S. Department of Health and Human Services 
7500 Security Boulevard 
Baltimore, MD 21244