“We plan to set up panels of bureaucrats with the power to kill off senior citizens.”

This is what has already happened: In November, 2006, the Centers for Medicare& Medicaid Services (CMS) issued a rule revising its method for calculating the expense component of physician payments under the Medicare Physician Fee Schedule for 2007. That rule instructs Medicare to reduce the payment for non-facility or outpatient cardiac catheterization procedures. Those payment reductions occur on top of numerous other Medicare payment cuts under the CMS Physician Fee Schedule. For example, reimbursement for outpatient cardiac catheterization was reduced by 23.3% in 2008 and by and additional 17% in 2009 and the reduction scheduled to take effect in 2010 for that same procedure will be and additional 59.9%, resulting in a 76% reduction for cardiac catheterizations over 3 years. The CMS rule is also scheduled to slash reimbursements for specialized cardiac imaging procedures by up to 60%. Those imaging procedures are the gold standard of preventive heart care and are essential to the early detection and treatment of cardiovascular disease. In most cases, those cuts will reduce reimbursement to below the cost of providing those services causing many cardiology practices to close or seriously evaluate whether they can continue to offer those procedures and whether or not they can continue to offer services to Medicare patients.

In Florida , over 3 million people receive health care services from the Medicare program and the payment reductions in the CMS rule will hinder access to proper preventative cardiac care for those millions of Medicare beneficiaries in Florida . They will essentially not receive the preventive care that allows them to live full lives but will be unaware of cardiovascular disease and peripheral arterial disease until they show symptoms such as a stroke or heart attack. Then it will be unlikely they will survive.

By denying senior citizens access to cardiac catheterization procedures and other preventive diagnostic procedures provided by their physicians in their offices, Medicare is forcing senior citizens to live with potential life threatening cardiovascular health problems until it is to late for proper treatment, thus reducing their life expectancy. Contrary to President Obama’s statement, bureaucrats, namely Medicare, are exercising the “POWER TO KILL OFF SENIOR CITIZENS”!

When cardiologists either stop providing preventive procedures or close their doors due to loss of income, consumers will be forced to seek these procedures in hospitals, which are not targeted by the reimbursement cuts and where already long wait times will be pushed to unrealistic and unimaginable limits due to the overwhelming volume being shifted from the non-hospital outpatient practices to hospitals where the cost of those same procedures and catheterizations are much higher than when performed at the physician’s outpatient office. Out-of-pocket expense for each Medicare beneficiary undergoing a cardiac catheterization performed in a hospital is $583.50 higher than in a private outpatient catheterization lab. Rather than spending less by cutting reimbursements to outpatient facilities, those cuts will close outpatient facilities and drive Medicare costs up by at least $86 MILLION because of the higher costs for the same procedures in hospitals.

The QUALITY OF, ACCESS TO and COST OF cardiac care will be severely and adversely impacted when those additional reductions are implemented. This will have a long and lasting effect on the public as we age and require preventive diagnostic procedures which will be difficult and expensive to obtain.

For some strange reason, the Federal government has not made any efforts to control or reverse these cuts. The hospital lobbyists have convinced the Federal government that outpatient testing and procedures are the root cause of increased health care costs giving hospitals more power to employ physicians and completely eradicate the private practices of cardiologists. This is because of Certificate of Need laws that allow the hospital lobby to prevent free competition successfully protecting their financial interests and posting huge profits. This is also because a panel of bureaucrats has been given the “power to kill off senior citizens.”

Physicians across the country are trying to raise awareness of the reimbursement cuts that are scheduled to take effect but no one is listening.

On August 21st, 2009, a rally was held in Orlando , FL and CNN had a cameraman there recording the event. He interviewed Dr Asad Qamar and his staff for more than 30 minutes with a video camera. Hopefully that recording will be aired either on television or on the internet. I have not seen it yet. So much air time has been given to President Obama’s Health Care Reform that this issue of Medicare reimbursement cuts has been ignored.

I’m writing this note to express my concerns about my ability to get the cardiovascular care I will need given the drastic Medicare payment cuts implemented and scheduled for implementation. Will someone in a position of authority intervene or will the CMS and Medicare be allowed to exercise the power kill our senior citizens?

Craig R. Davis