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Wednesday, Dec 24, 2014
Commentary

Florida seniors get the brunt of Medicare cuts

BY JOE CROZIER
Special to The Tampa Tribune

Published:

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Finding health care could soon get harder for many Floridians with conditions such as cancer, multiple sclerosis and rheumatoid arthritis.

Seniors with illnesses such as these often rely on medicines covered by Medicare Part B - drugs that doctors buy and administer by injection or infusion into the bloodstream. Unfortunately, attempts to trim the federal budget may leave many doctors unable to treat Part B patients. Seniors, including millions in Florida, could have a much harder time getting the treatments they need.

Slashing Medicare Part B is no way to reduce federal spending. Lawmakers need to reject any additional cuts to the program that could worsen the plight of Florida's Medicare beneficiaries.

Doctors already are coping with the recent across-the-board sequestration cuts. Before these steep reductions, doctors who administered drugs to patients under Part B were reimbursed for the Average Sales Price of those medicines plus 6 percent, a convention known as "ASP+6%." The extra 6 percent is intended to cover expenses, including shipping, storage and supplies. That add-on has been especially important in rural counties such as Hamilton and Union, where costs can be high.

As of April 1, however, sequestration slashed reimbursement rates to roughly ASP+4 percent - a cut amounting to billions of dollars.

To make matters worse, some in Washington have proposed reducing the reimbursement rate even further to ASP+3 percent, a reform last debated in 2011. Such dramatic cuts would put many physicians and health clinics in a difficult spot: lose money on Part B patients or turn those seniors away.

Florida Medicare beneficiaries will be hit particularly hard. Even before sequestration, a serious physician shortage left Sunshine State seniors struggling to find access to medical care. At the same time, the state's small health clinics are in the midst of crisis. According to a report released last year by the Community Oncology Alliance (COA), Florida has lost 24 cancer clinics since 2008, and 28 more are facing financial difficulties.

Additional cuts to reimbursement rates for providers will only add to the woes of Florida clinics. In fact, when the COA asked clinics how they would respond to sequestration cuts to Medicare Part B, 69 percent of office-based practices reported that changes to operations and/or patient treatment already had occurred. Nearly half reported that they already are forced to send some patients elsewhere for treatment. One in five is laying off staff. The deeper cuts now being considered for Part B drugs likely are to result in even more physicians needing to consider taking the same types of actions.

For the 9 percent of Floridians who live in rural areas, potential Part B reductions will be especially problematic. Not only are rural clinics the ones most likely to lose money because of higher costs, but seniors in those areas have to travel long distances if forced to find another doctor who will see them. These cuts could end up costing Medicare more money. When patients can't stick to a prescribed treatment regimen, their health suffers and costs can rise.

Lawmakers must protect Part B from more budget cuts and reject any measure that could further undermine the availability of care in the future.

Joe Crozier is president and CEO of Community Health Charities of Florida.

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