Some Physicians Refuse To Accept Patients Enrolled In Medicare Advantage Plans

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Primary Care / General Practice
Article Date: 11 Dec 2007 - 9:00 PDT

email to a friend   printer friendly   opinions  

With the Medicare open enrollment period ending at the end of the month, some physicians are saying that they will not accept patients enrolled in Medicare Advantage plans, the Des Moines Register reports. The Iowa Clinic and Minnesota's Mayo Clinic both are denying beneficiaries who are enrolled in most MA plans.

Iowa Clinic CEO Ed Brown said that the facility will not accept MA plans that reimburse at the same rate as traditional Medicare because the private plans receive more funding from the federal government. A Mayo Clinic spokesperson said the clinic has a similar policy. CMS has confirmed that it pays MA plan providers about 12% more than traditional Medicare. MA plan providers say that they offer extra benefits and simplified paperwork, according to the Register.

Brown said that the Iowa Clinic will provide interim care for current patients who have switched plans. Michael Kitchell, chair of the Iowa Medical Society, said that he agrees with the American Medical Association that MA plans are paid too much but that he doubts many physicians in the state will follow the Iowa Clinic's lead. Kitchell noted that a bill in Congress would cut MA payments but that President Bush has threatened to veto it. Humana, which provides MA plans, has a printed disclaimer that warns beneficiaries to make sure their physicians accept MA plans before signing up for it.

Sen. Chuck Grassley (R-Iowa) defended MA plans and labeled the physicians who refuse MA plans as "spiteful." He said, "There's no way you can win an argument with senior citizens by saying, as a doctor, 'I will take a traditional Medicare person that's going to pay me $100, but I'm not going to take anybody that's in Medicare Advantage that's going to be paying me the same $100 because I don't like the way the company may be making some more money'" (Leys, Des Moines Register, 12/9).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

• Additional
• References
• Citations