ASCRS warns of upcoming problems in Medicare debate

Fairfax, VA-In a press release, the American Society of Cataract and Refractive Surgery (ASCRS) said it recognizes the achievement of the recently passed Medicare Improvements for Patients and Providers Act of 2008, stopping the 10.6% Medicare physician payment cut, but also recognizes the hard road ahead.

"...We must be frank in recognizing that it is little more than a temporary solution, which only postpones the difficult choices that must be made to address the underlying problems in the physician payment system, and will only make it more expensive and difficult to fix those problems in the long term," said ASCRS President Bradford Shingleton, MD.

Current problems must be corrected before the medical industry can move on, according to the press release.

"Policymakers must fix the Sustainable Growth Rate Formula (SGR) if we are to avoid an ongoing annual crisis in Medicare reimbursement," said Priscilla Arnold, MD, ASCRS government relations committee chairwoman. "The SGR in combination with short-term fixes like the current legislation, that have not been adequately funded, have exacerbated the problem and cause physicians to face a 21% reduction in Medicare reimbursements in 2010, as well as additional cuts scheduled for the next several years."

ASCRS did not support this legislation because the funding mechanism in the bill causes a 21% physician payment reduction in 2010. Other provisions that ASCRS regards as problematic include:

•  ASCRS does not support a phase-in to mandatory electronic prescribing because it is an unfunded mandate at a time when physicians are facing reductions in Medicare reimbursement.

• ASCRS does not support the Physician Compare Program requirement of posting on the Centers for Medicare and Medicaid Services website the names of physicians who successfully participated in the Physician Quality Reporting Initiative. The program is potentially misleading to patients because it reflects only a doctors reporting of certain processes and does not measure patient outcomes. There are other problems with the reporting program itself-so many physicians will not be receiving the bonus payment-and therefore, are considered to have not participated successfully. This has no bearing on the quality of care provided by the other physicians who were not "successful" or did not participate.

• ASCRS has concerns with expansion of the Physician Quality Reporting Initiative (PQRI) through 2010, at this time, because of insufficient experience with it. It began in 2007, no reporting of initial experience has taken place and it is inappropriate to expand the program without an assessment and public discussion of its initial experience. We also believe that there needs to be a clearly defined and transparent process for the development, validation, and endorsement of measures.