U.S. restores $6.9 million for Medicare payments Doctors had lobbied against planned cuts

August 27, 1991|By New York Times News Service

WASHINGTON — A headline in yesterday's editions of The Sun gave an incorrect figure for the amount the United States plans to restore to a proposed schedule of Medicare fees. The correct amount, as indicated in the article, is $6.9 billion.

The Sun regrets the error.

WASHINGTON -- Federal health officials said yesterday that they would revise a proposed schedule of Medicare fees to restore $6.9 billion that was to have been cut from payments to doctors.

The changes come in response to political pressure from Congress and a torrent of complaints about the cuts from doctors around the country.


The cuts were proposed three months ago by the Bush administration as part of the fee schedule, which represents a major overhaul of Medicare's reimbursement policy.

With the latest changes, Medicare would spend $191 billion for doctors' services over the next five years, rather than the $184 billion of the original proposal.

Health-care economists had said that elderly people would have had more trouble getting medical care under the original fee proposal because doctors would be less willing to take Medicare patients.

Doctors had charged that the administration was breaking faith with the nation's physicians by using the fee schedule to save money for the government.

The fee schedule was mandated by Congress, but not with the aim of cutting Medicare spending. Rather, it was intended to spread money more fairly, to reflect the work, time and effort that go into each service provided by doctors.

The fee schedule, set to take effect in January 1992, is supposed to increase Medicare payments for family physicians and general practitioners, while reducing payments for some specialists, including surgeons.

The apparent success of the doctors' lobbying effort, led by the American Medical Association, illustrates why it is politically difficult to impose comprehensive controls on health care costs.

"It shows what kind of resistance there is in this country to the government really controlling costs," said Dr. Sidney M. Wolfe, director of Public Citizen's Health Research Group.

Gail R. Wilensky, head of the federal Health Care Financing Administration, which runs Medicare, has described the cuts as an "unintended consequence" of the 1989 law that established the Medicare fee schedule.

A senior official who supervises Medicare, and who refused to be identified, said yesterday, "We found a small bit of flexibility that allows us to get around the problem," by using a new interpretation of the law.

In a recent letter to Dr. Louis W. Sullivan, the secretary of health and human services, Senate leaders from both parties said that they "clearly anticipated that the fee schedule would neither increase nor decrease Medicare spending for physicians' services."

The AMA and other medical groups reacted warily yesterday, saying that they had not analyzed details of the administration's new proposal.

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