If the proposal is adopted by Congress, currently projected cuts in the Medicare anesthesia conversion factor for 2001 and 2002 related to the practice expense transition would not occur. A vehicle for this proposal would likely be Medicare refinement legislation this fall, now expected to be almost a certainty in light of a growing budget surplus. Its enactment was aided by a call from President Clinton in late June for further provider relief from the strictures of the Balanced Budget Act of 1997. No parallel bill has been introduced in the Senate, and chances of passage in that body before adjournment are highly problematic. The concept of collective physician negotiation is virulently opposed by the insurance and managed care industries, and the GOP Senate leadership has shown no inclination to move such a bill in the face of this opposition.
Patient safety is our main concern, for two reasons.
First, HHS rejected an identical proposal eight years ago, citing patient safety concerns based on a review of then-existing scientific outcomes data. We respectfully urge that you return the draft rule to the Department of Health and Human Services, with advice that a further comparative outcomes study based on comprehensive current scientific data be conducted prior to a policy change. The safety of American patients demands no less. The Silber study is an anesthesia outcomes study undertaken by Jeffrey H. Silber, M.D., Ph.D., and colleagues at the University of Pennsylvania. Outcomes information was derived from Medicare billing data.