National Social Worker Call in Day EXTENDED
Tuesday, November 12th THROUGH Friday, November 15th
Protesting Cuts to the Medicare Physician Fee Schedule

NASW Needs Social Workers to Make Calls to Congress Urging Immediate Action
Access Issue for Consumers - Reimbursement Issue for Clinical Social Workers

DATES: Tuesday, November 12th, 2002 through Friday, November 15th

ACTION: Call 202-224-3121, the U.S. Capitol Switchboard, and let your U.S. Senators and U.S. Representative know you oppose recent and future cuts to the Medicare Physician Fee Schedule!

REASON: In the United States, clinical social workers comprise one of the largest groups of mental health providers. NASW also strongly believes in the integrity of the Medicare program. As such, social workers need to make a strong statement to Capitol Hill about the importance of adequate reimbursement for all health care services rendered to Medicare beneficiaries-- but especially those mental health services provided by clinical social workers.
SAMPLE SCRIPT:
Hello. May I speak to the staffer that handles Medicare issues, please?

I'm calling as a constituent and a member of the National Association of Social Workers to demand that Congress fix the Physician Fee Schedule Cut problem NOW!

The current situation is bad for both Medicare beneficiaries and providers. Recent studies have shown this year's 5.4% cut has already led to access problems-- the upcoming January 1 cuts will make this terrible situation even worse! Current provider reimbursement levels have been slashed below 2001 levels and will be cut by an additional 12% by 2005. These cuts make it extremely difficult for health care providers like clinical social workers and physicians to accept new Medicare patients. Patients’ out-of-pocket expenses will continue to rise. The end result will seriously jeopardize the ability of Medicare patients to access services and the ability of clinical social workers to provide services to Medicare beneficiaries.

Congress must take action NOW and pass legislation immediately to stop these cuts and fix the Medicare payment formula to avert future crises like this! Please don't make patients and providers make decisions they shouldn't have to!

Will the Senator/Representative support immediate legislative action to fix the flawed Medicare formula and halt these cuts?

Thank you for your consideration and time.

DON’T FORGET TO GIVE THE STAFFER YOUR NAME AND ADDRESS.

Let social workers be heard from November 12th- 15th!

ADDITIONAL PHYSICIAN FEE SCHEDULE INFORMATION

ISSUE

On January 1, 2002, all health care professionals, including clinical social workers, experienced a 5.4% across-the-board cut in Medicare payments for all services. NASW joins the American Medical Association among others in calling for the elimination of the current update formula, which requires these cuts. Another cut is scheduled to take place on January 1, 2003.

BACKGROUND

The Centers for Medicare and Medicaid Services (CMS) annually update the rate at which health care practitioners are reimbursed for services rendered under the Medicare program, entitled the Physician Fee Schedule. Changes become effective each January 1 and affect all the health care professions, paid under the Physician Fee Schedule including clinical social workers, physicians, chiropractors, optometrists, and nurse practitioners. The update formula factors the sustainable growth rate (SGR), in its calculations. The SGR represents the rate of increase in Medicare expenditures for physician services, in an attempt to control the growth of Medicare expenditures for physician services. The SGR links Medicare Part B spending outlays to business cycles too. Thus, the update formula is fatally flawed since business cycles do not necessarily correspond to patient need or actual health care utilization. And despite legislation passed by Congress in 1999 that attempted to reduce the volatility of the update formula, significant oscillations continue to happen.

The Fiscal Year 2002 Physician Fee Schedule, published by CMS on November 1, 2001, cut reimbursements by an average of 5.4%. That cut was the fourth reduction within 11 years for Medicare health care professional payment rates. But during the same time frame, Medicare payments have only risen by an average of just 1.1% a year. The gap between cost inflation and Medicare payment updates has begun to take its toll and further cuts will certainly exacerbate the situation.

In the last year or so, access problems for Medicare beneficiaries already have been reported in Atlanta, Phoenix, Albuquerque, Annapolis, Denver, Austin, Spokane, northern California and Idaho. Furthermore, a recent American Medical Association survey found that if additional cuts are made by Medicare, 42% of physicians polled reported that they would neither remain nor become Medicare providers.

The U.S. House of Representatives passed language as part of a larger prescription benefit package (H.R. 4954) to address this issue. To date, the U.S. Senate has yet to discuss the matter. NASW hopes that the Congress will see fit to pass legislation to fix the formula during its upcoming lame duck session.

For more information, contact Francesca Fierro O'Reilly, NASW Senior Government Relations Associate, at fforeilly@naswdc.org or 202-336-8311.