MARBLE FALLS, Texas (KXAN) - Diminishing reimbursements and payment delays have area doctorsopting out of Medicare.
"It was continual frustration, lots and lots of paper work, lotsof coding," explained Dersch. "The patients get reduced downto numbers. If you make a mistake, even accidental, it can bea felony."
Dersch's decision to sever all ties with the program is rare,but growing more commonplace as Medicare pay cuts loom now thatCongress failed to delay the 21 percent Medicare cut which tookeffect June 1.
Congressional inaction has national health care advocatesoutraged.
"The Senate has turned it's back on seniors," said Dr. JamesRohack, president of the American MedicalAssociation, in a statement issued Friday. "Senators are moreinterested in heading home for the holiday than in preventing aMedicare meltdown for seniors...Already, about one in four Medicarepatients looking for a new primary care physician have troublefinding one, and Congressional inaction will make it muchworse."
Dersch admitted her decision to opt out didn't come easy.
"I was worried," Dersch said.
Unlike other doctors, Dersch is not turning away medicarepatients.
Instead, she is seeing them only on a private-contracting basis,meaning she nor her patients can make any Medicare paymentclaims.
Dersch's system also allows her to charge what her servicesactually cost, not what the government says they are worth.
"We just try to charge what is fair and it is less than it costsme to get my haircut," Dersch added.
She also is choosing not to charge patients 90 and older for herservices and she even makes house calls.
"We probably see at least one free person a day. We see alot of people for free," Dersch said.
Minor sacrifices that save her from dealing with what criticscall "an imploding" government funded program.
The Senate is due back in session June 7. Doctors who stillaccept Medicare and health care advocates are holding out hope thatfreezing payment cuts until December 2011 will be voted intolaw.
If passed, this will not be the first time payment cuts aredelayed. There have been nine delays over the past eight years.
Meanwhile, Medicare claims are now on hold for 10 days to allowpassage of the bill.
1945- Harry Truman asks Congress to developlegislation establishing a national health insurance plan.
1965- President Lyndon B. Johnson signs Medicareand Medicaid into law. President Truman is the first toenroll and Medicare Part B premium is $3.
1972- Payments to HMOs are authorized.
1983-Most federal civilian employees becomecovered.
1984-All federal employees, including thepresident, become covered.
1988- Medicare benefits are overhauled. Coveragefor catastrophic illness, routine mammograms and prescription drugsnow included in benefits.
1989- Catastrophic illness and routine mammographyno longer included in benefits. Coverage, however, for pap smearsis added.
1992-Physician services payments are based on feeschedule.
1997-Medicare+Choice is enacted under the BalancedBudget Act. Some provisions prove to be so financiallyrestrictive Congress is forced to revisit the issue in 1999.
1999-Congress reviews and relaxes fundingrestriction under the Balanced Budget Act.
2000 -Medicare Part B premium is $45.40 per month.
2007-Medicare Payment Advisory Commission(MedPAC), established in 2007 to advise Congress on theprogram.
January 1, 2010-21 percent Medicare payment cutscheduled to take place. Congress later votes to push backthe date.
June 1, 2010-Congress fails to meet Medicaredeadline, imposing the 21 percent cut in Medicare payments.
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