Eyeworld

EW NEWS & OPINION 18 September 2014 Private contracting Larry E. Patterson, MD Crossville, Tenn. This was my fi rst year participating in the Alliance of Specialty Medicine Legislative Fly-In as a part of a rather large ASCRS contingency. I take fl y- ins very seriously—I even fl y myself to them! One of the issues brought up at this year's meeting was the problem that arises when Medicare patients wish to contract private- ly with their doctor for a medical service. For some time, the law has been written in such a way that our seniors who wish to see a doctor who doesn't accept Medicare must pay for their care entirely out of their own pocket. Recent legislation, the Medicare Patient Empowerment Act (S. 236 and H.R. 1310), attempts to rectify this situation. This would establish a Medicare payment option for both patients and physicians to freely contract on a case-by-case basis, without penalty, for Medicare physician services, while allowing patients to use their Medicare ben- efi ts, and for physicians to bill the patient additional amounts beyond what Medicare allows for covered procedures. Physicians could con- tinue to treat other patients as they choose under either the participat- ing or non-participating status. Why is this needed? We all know that bureaucratic burdens are growing, payment rates have lagged behind the costs of providing care, pay cuts are threatened annually, and schedules in many doctors' offi ces are bursting at the seams. These factors combined are making it increasingly diffi cult for many to continue caring for Medicare patients. While many doctors keep seeing patients well after they've reached 65, many, even in my own rural community, have been forced to stop seeing new Medicare patients. This will only worsen with time as a large infl ux of Baby Boomers is entering retirement, and the country's doctor shortage will continue to grow. Many seniors will fi nd they simply can't fi nd a doctor. This bill will help ensure that seniors can see the doctor they choose, even in the case where that doctor fi nds he or she can no longer accept Medicare. How would it work? It's simple actually. Both the doctor and patient sign a contract that clearly explains the patient's rights, responsibilities, and payment rates. Medicare would pay just like it does today. The patient and doctor can decide in their contract who receives the payment. Either way, the patient pays the difference in what Medicare pays and what they both agreed to in the contract. Importantly, this is not a sepa- rate Medicare plan. It doesn't create a new government bureaucracy. This is only between the doctor and the patient. It will allow patients to see whoever they wish and still enjoy the insurance benefi ts they've been paying into for their whole life, without being banished from the program. As it stands now, if you want to see a doctor who isn't accepting Medicare, you have to pay for the entire bill out of your own pocket. There is of course a concurrent problem for physicians. Currently, if you decide to "opt out" of Medi- care to privately contract with even one patient, you are banned from Medicare for 2 years. This has the effect of making private contracting essentially impossible, especially for most ophthalmologists. This legislation was reintro- duced in February 7, 2013 by Sen. Lisa Murkowski (R-AK). There are three original physician cosponsors in the Senate: Sen. John Barrasso, MD (R-WY), Sen. Tom Coburn, MD (R-OK), and Sen. Rand Paul, MD (R-KY). The companion bill was in- troduced in the house on March 23, 2013 by Rep. Tom Price (R-GA). This is legislation we can all get behind. Call your representative or senator and let your voice be heard! Easing regulatory burden on physicians and practices Vonda Syler, COE Fayetteville, Ark. As a member of the Government Relations Committee, I was honored to attend the Alliance of Specialty Medicine Legislative Fly-In. The Alliance represents more than 100,000 physicians. ASCRS physi- cians are represented as a member of the Alliance. We are given the op- portunity to interact with infl uential members of Congress and their staff on the issues affecting physicians. One of the many issues discussed was regulatory burdens on physi- cians and their practices. We asked Congress to move for- ward on the reduction of regulatory burdens to help physicians and their practices by doing the following: • Use positive fi nancial incentives linking physician payment to meaningful quality measures, not penalties • Ensure transparent adjustments to physician payment values Practice Makes Perfect! KITARO ® Lab Kits. The Revolutionary Training Tools to Master Cataract Surgery Kitaro Lab Kits offer surgeons the ability to practice various procedures and techniques repeatedly using synthetic but realistic materials without complicated preparation and expensive consumable goods such as those needed for porcine wet labs. NEW FCI-Ophthalmics.com 800.932.4202 THREE NEW KITS NOW AVAILABLE: KITARO Dry/Wet Lab to practice: • Capsulorhexis • Grooving & Splitting the Nucleus • Phacoemulsification • Wound Construction • IOL Insertion KITARO Complex Lab 1 to practice: • Small Pupil Management • Weak/Ruptured Zonules • IOL Transcleral Fixation KITARO Complex Lab 2 to practice: • Conventional Extracapsular Extraction (ECCE) • Posterior Capsule Rupture Management (PCRM) Visit FCI-Ophthalmics.com to watch the KITARO Training Video. Call us at 800-932-4202 to receive promotional pricing on your first KITARO Lab Kit. The Alliance of Specialty Medicine continued from page 14 continued on page 20

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