HCFA, in its zeal to reduce waste, fraud and abuse, has imposed mountains of needlessly complex regulations. Physicians are spending more time on paperwork and less time on patient care, and some are retiring or leaving the Medicare program. We urge Congress to ensure that HCFA allocate enough resources for education on these regulations and require HCFA to reform its post-payment audit process. Regulatory costs imposed on physicians under BBA are not taken into account when HCFA updates the physician payment schedule. We recommend that HHS, including HCFA, be required to calculate the costs of new regulations and increase Medicare physician payment rates each year to account for these costs.
More work is needed to address physician practice expense.
HCFA's current practice expense methodology and data do not accurately reflect physicians' actual practice costs. We urge Congress to implement a specific formula supported by the AMA and 40 physician organizations, teaching hospitals, medical schools, and clinics. The downstream effects of Medicare cuts under BBA are especially difficult for medical residents, who are required to re-pay enormous student loans, while being paid only a small stipend.