Letter on Medicare Physician
Payment Relief Signed by Medical School Deans, Sent to Senate
Finance Committee and Full Senate
September 19, 2002
The Deans of the undersigned medical schools strongly urge
you to pass legislation that will provide both short- and
long-term relief from the flawed methodology used to calculate
payments made under the Medicare Physician Fee Schedule. It
is vitally important that Congress resolve this issue before
it adjourns.
In its June 28, 2002, Proposed Rule regarding the CY 2003
Physician Fee Schedule, the Centers for Medicare and Medicaid
Services (CMS) projected a negative 4.4 percent update to
the Conversion Factor. This would be the second consecutive
reduction in the update, following a 5.4 percent reduction
in CY 2002. As the leaders of medical schools with multispecialty
faculty practices that serve a large number of Medicare beneficiaries,
we are greatly concerned that the methodology used to calculate
the updates has failed to reflect the actual cost of providing
physician services. This is a highly critical issue for us,
given that our academic clinical faculties represent nearly
one-sixth of all Medicare physicians and receive approximately
$2.5 billion in Medicare reimbursements annually.
We are responsible for the financial planning and oversight
of fiscally vulnerable institutions, and are very concerned
about the volatility of updates. In light of the fact that
faculty practice revenues, on average, represent about 35
percent of a medical school's total revenue, unstable Medicare
payments jeopardize our ability to effectively manage the
resources that support our core missions of medical education,
research, clinical services, and providing charity care.
Over three-quarters of the Senate has cosponsored legislation
(the "Medicare Physician Payment Fairness Act,"
S.
1707) that would halt the scheduled reductions and call
for a more equitable alternative to the current payment methodology.
Despite the indication of strong bipartisan support, no action
has been taken.
Legislation passed by the House, "The Medicare Modernization
and Prescription Drug Act of 2002" (H.R.
4954), takes an important step toward resolving the problematic
physician payment system. However, it does not address the
5.4 percent reduction in the CY 2002 CF, nor does it call
for a long-term solution to the flawed payment formula. We
hope the Senate will improve upon the physician provisions
within H.R. 4954 and produce legislation that diminishes the
volatility and inadequacy of physician payments in the long
run.
Stable and adequate Medicare physician payments are critical
to ensuring that seniors have continued access to the high-quality
and innovative healthcare provided by academic physicians.
Senate passage of effective physician payment legislation
will help preserve that access and assure the highest quality
of life possible for all seniors.
Sincerely,
Albany Medical College
Albert Einstein College of Medicine
Baylor College of Medicine
Boston University School of Medicine
Brown Medical School
Case Western Reserve University School of Medicine
Chicago Medical School Finch University of Health Sciences
Columbia University College of Physicians and Surgeons
Creighton University School of Medicine
Dartmouth Medical School
David Geffen School of Medicine at UCLA
Drexel University College of Medicine
Duke University School of Medicine
East Carolina University Brody School of Medicine
East Tennessee State University James H. Quillen College of
Medicine
Eastern Virginia Medical School
Emory University School of Medicine
George Washington University School of Medicine and Health
Sciences
Georgetown University School of Medicine
Harvard Medical School
Howard University College of Medicine
Johns Hopkins University School of Medicine
Indiana University School of Medicine
Jefferson Medical College
Joan and Sanford I. Weill Medical College and Graduate School
of Medical Sciences of Cornell University
Louisiana State University School of Medicine in New Orleans
Louisiana State University School of Medicine in Shreveport
Loyola University Stritch School of Medicine
Marshall University Joan C. Edwards School of Medicine
Mayo Medical School
Medical College of Georgia School of Medicine
Medical College of Ohio
Medical College of Wisconsin
Mercer University School of Medicine
Michigan State University College of Human Medicine
Mount Sinai School of Medicine
New York University School of Medicine
Northeastern Ohio University College of Medicine
Northwestern University Feinberg School of Medicine
Ohio State University College of Medicine and Public Health
Oregon Health and Science University
Pennsylvania State University College of Medicine
Ponce School of Medicine
St. Louis University School of Medicine
Southern Illinois University School of Medicine
Stanford University School of Medicine
State University of New York Upstate Medical Center
Stony Brook University Health Sciences Center School of Medicine
Temple University School of Medicine
Texas Tech University Health Sciences Center School of Medicine
Tufts University School of Medicine
Tulane University School of Medicine
University of Alabama School of Medicine
University of Arizona College of Medicine
University of Arkansas Medical Sciences College of Medicine
University at Buffalo State University of New York School
of Medicine & Biomedical Sciences
University of California Davis School of Medicine
University of California Irvine College of Medicine
University of California San Diego School of Medicine
University of California San Francisco School of Medicine
University of Chicago Pritzker School of Medicine
University of Cincinnati College of Medicine
University of Colorado School of Medicine
University of Connecticut School of Medicine
University of Florida College of Medicine
University of Hawaii John A. Burns School of Medicine
University of Iowa Roy J. and Lucille A. Carver College of
Medicine
University of Kansas School of Medicine
University of Kentucky College of Medicine
University of Louisville School of Medicine
University of Maryland School of Medicine
University of Massachusetts Medical School
UMDNJ-New Jersey Medical School
UMDNJ-Robert Wood Johnson Medical School
University of Miami School of Medicine
University of Michigan Medical School
University of Missouri-Columbia School of Medicine
University of Missouri-Kansas City School of Medicine
University of Nebraska College of Medicine
University of New Mexico School of Medicine
University of North Carolina at Chapel Hill School of Medicine
University of North Dakota School of Medicine and Health Sciences
University of Oklahoma College of Medicine
University of Pennsylvania School of Medicine
University of Pittsburgh School of Medicine
University of Puerto Rico
University of Rochester School of Medicine and Dentistry
University of South Alabama College of Medicine
University of Southern California Keck School of Medicine
University of South Carolina School of Medicine
University of South Dakota School of Medicine
University of South Florida College of Medicine
University of Texas Medical Branch at Galveston
University of Texas Medical School at Houston
University of Utah Medical School
University of Vermont College of Medicine
University of Virginia School of Medicine
University of Washington School of Medicine
University of Wisconsin Medical School
Vanderbilt School of Medicine
Virginia Commonwealth University School of Medicine
Wake Forest University School of Medicine
Washington University School of Medicine in St. Louis
West Virginia University School of Medicine
Wright State University School of Medicine
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