"[Medicare] third party administrators have already sent the 2012 fee schedule reflecting those cuts to providers,” says Katherine Nordal, executive director of the Practice Directorate at the American Psychological Association (APA). (That’s a 32.4% cut--the other 2% wouldn’t kick in until 2013.)
“They want to give everybody a heads up. But we're hoping they'll have to do the same thing as last year, which was to readjust and supplement the . Our government relations staff thinks it will be resolved and the 5% cut will be avoided, too.”
Not everyone’s so confident. “I’m less optimistic now than I’ve usually been,” says Laura Groshong, a lobbyist and director of government relations with the Clinical Social Work Association (CSWA). “It’s hard to believe that a 34% cut would be allowed, and I’m hoping we can come up with a way to at least minimize it. But at this point I have to be realistic and look at what actually could happen. It’s a very discouraging time.”
As the year ended, leaders were trying to come up with an agreement on the doc fix. One proposal was for a two-month temporary pact that would prevent a Medicare cut until March 1.
A brighter spot in the Medicare picture for 2012 is the continued reduction in copays, which have traditionally been 50%. But because of the parity law, a copay of 20% is being phased in. It will be 40% in 2012, 35% in 2013 and 20% in 2014.
“I think that will make mental health services much more accessible for older people,” Nordal says.
But Groshong believes any growth in Medicare mental health services “depends on how many providers are going to keep seeing Medicare patients. Because if these cuts go into effect, you’re going to see a lot of people deciding not to take Medicare.”
Contacts: 1) Laura Groshong, CSWA, Seattle, WA, (206)524-3690, lwgroshong@comcast.net; 2) Katherine Nordal, American Psychological Association, Washington, DC, (202)336-5913, email: knordal@apa.org.
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