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More Doctors Refusing to Treat People on Medicare

  • August 29th, 2002

It's becoming increasingly difficult for Medicare beneficiaries in a number of states to find a doctor willing to take them on as a patient, according to a new survey by the Medicare Rights Center, a national, non-profit consumer service organization.

The Center found that Medicare recipients in eight states--Tennessee, Missouri, Arizona, Virginia, New Hampshire, Texas, Rhode Island, and New Mexico'‚ÄĚhave had a harder time finding a doctor who accepts new Medicare patients since January 2002, when a 5.4 percent cut in Medicare payments to doctors went into effect. Respondents from three of the states--New Mexico, Tennessee and New Hampshire--reported that doctors had informed their clients that the lower payment rates were the reason they would not be taken as new patients.

"This may be a looming emergency," said Robert M. Hayes, president of the Center. "When a patient can''t find a physician who accepts Medicare, the patient often goes without needed care. Congress must determine why doctors are refusing to treat people with Medicare."

Medicare counselors and advocates in four states--New Jersey, Arizona, Tennessee and Virginia--reported receiving more calls since January 2002 from people who could not find specialists willing to take new Medicare patients. The specialists cited most frequently as restricting their practices from new Medicare patients were dermatologists, oral surgeons and psychiatrists.

Historically, limited access to doctors has been a problem for Medicare beneficiaries living in rural areas because they generally have lower incomes, fewer supplemental insurance and Medicare HMO options, and transportation difficulties. People enrolled in Medicare HMOs may also face difficulty in both finding and keeping doctors because HMOs report having trouble identifying doctors willing to accept their rates.

Congress adopted the formula that currently determines the Medicare physician payment rate as part of the 1997 Balanced Budget Act. Critics of the formula argue that it does not sufficiently reflect increases in the cost of providing care and should be replaced with a formula that better factors in the costs to providers.

To download the Medicare Rights Center report 'Have People With Medicare Lost Access to Doctors?' in PDF format, go to: http://www.medicarerights.org/FactSheet-AccessDocs.pdf

Local Elder Law Attorneys in Ashburn, VA

Margaret O'Reilly

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Mindy Felinton

Felinton Elder Law & Estate Planning Centers
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Last Modified: 08/29/2002

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