POINT OF VIEW Proposed Medicare tinkering puts Florida seniors at risk

One in five Floridians depends on Medicare. But federal officials are considering dramatic changes to the benefit that could drive some health care providers out of business, depriving many in the state of the important care they need.

MedPAC — the Medicare Payment Advisory Commission — will soon recommend steep cuts to reimbursement rates for Medicare Part B, the program that covers treatments that must be administered under the supervision of a doctor or nurse.

The current Part B payment system requires providers to pay for these treatments themselves and then bill the program for reimbursement. Medicare reimburses doctors for the average price of the drug plus a 6 percent add-on to cover administrative overhead, such as storage and handling.

For many health clinics, especially small, rural ones, that add-on isn’t enough to cover overhead and operating costs. Over the past decade, 37 Florida cancer clinics have been forced to shut down and more than 80 have been purchased by hospitals or larger practices. The clinics simply aren’t receiving adequate reimbursements to stay afloat on their own.

The proposal from MedPAC would make this problem much worse. It would cut Part B reimbursements by slashing that administrative add-on in half. If the cuts take effect, many more clinics would close. These clinics have deep ties to local communities. The nurses and doctors who work there have spent years treating the same patients and developing a deep understanding of their particular needs. A big hospital can’t deliver that sort of personalized care.

Hispanics would suffer immensely from these changes.

This group is exceptionally reliant on Part B. Elderly Hispanics are twice as likely as the overall senior population to have incomes below the poverty line. They can’t afford to supplement public insurance with a private plan or pay out-of-pocket. Part B is their health care lifeline. If the provider pool shrinks, their care could disappear.

Cancer clinic closures would particularly devastate this population. Cancer is the No. 1 cause of death among Hispanics. Many will be forced to travel long distances to hospitals to receive chemotherapy and other Part B-covered services, or simply go without care entirely, leading to more suffering and early death.

Unfortunately, reimbursement cuts aren’t the only MedPAC proposal that will harm patients. The group also wants to combine billing codes for advanced medicines and less expensive medicines that are “therapeutically similar.”

MedPAC’s recommendations must be scrapped.


Editor’s note: Julio Fuentes is president and CEO of the Florida State Hispanic Chamber of Commerce.

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