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Medicare, Mayo Clinic, and Misinformation

by on Apr. 18, 2010, under Health

A recent post by Compound Captive on Tucsoncitizen.com (April 15th) was a good example of the misinformation that is out there concerning the Health Care Reform Law and Medicare in general. Included in the post were several claims about Medicare that were incorrect.  I replied to that post yesterday and thought it would make a good post for my own Medicare and More blog.

The main point of the Compound Captive post was that Mayo Clinics in Arizona are no longer accepting Medicare patients.  This is incorrect.  On January 5th, the Mayo Clinic Health Policy Blog corrected the misconception and misinformation that had been widely reported. Here is the first part of the Mayo Health Policy Blog post:

Mayo Clinic in Arizona Continues to Provide Care for Thousands of Medicare Patients

Some recent media reports have inaccurately stated that Mayo Clinic in Arizona is no longer seeing any Medicare patients. This is not true.

Rather, a five-physician Mayo Clinic Arizona family practice clinic in Glendale, Ariz., has opted out of Medicare as part of a Mayo Clinic time-limited trial that will be reviewed at its conclusion. This means that Medicare will no longer reimburse Mayo Clinic for primary care services at this specific primary care facility, not at Mayo Clinic in Arizona overall. This affects only primary care office visits for the five Mayo family practice physicians at this site.  Specialty care, laboratory services, imaging studies and ancillary services at Mayo Clinic are still covered by Medicare. Current Medicare patients may continue receiving primary care at the Glendale clinic but will be required to pay out-of-pocket for office visits.  ( see http://healthpolicyblog.mayoclinic.org/2010/01/05/medicare-and-mayo-clinic-in-arizona/ )

In a previous post on this Medicare and More blog,  I reported that under the Health Care Reform Law, primary doctors will get a 10% increase in their Medicare payments.  Across the country, it is primary care doctors who are limiting the number of Medicare patients in their practices.  The Heath Care Reform Law addresses this problem.

Compound Captive wrote in his blog that “a year ago federal officials confirmed that fraud, waste and abuse was habitual in several specific areas of Medicare, but to date have taken no action to fix these known problems”.   In fact, the The Health Care Reform Law commits the government to finding and prosecuting Medicare fraud.  Under the law, funding will  be increased to expand efforts to find and prosecute Medicare fraud.  Medicare will double the number of investigative offices it has across the country so the agency will have the people and resources to address this serious problem.  No other administration has taken such an aggressive approach to fighting fraud and abuse in the Medicare system.

Compound Captive also wrote that the Medicare “program’s reimbursement to medical providers is so slow…“  This is absolutely incorrect.   In fact, Medicare pays claims as quickly as or faster than insurance companies.  I have heard this from many sources, but just last week I had a conversation with my own doctor about Medicare.   This doctor is a specialist and he doesn’t like the Health Care Reform Law, but he told me that Medicare pays claims quickly and consistently.  He also told me stories about insurance companies and how they delay payment for months by  rejecting claims and requiring doctors to submit more and more paperwork. This doctor doesn’t like the new law, but he doesn’t like insurance companies either.  He did say that insurance companies pay from 10% to 20% more than Medicare for the same procedure – but Medicare doesn’t deny claims and delay payment, so doctors at least know they can count on timely payment from Medicare.

The many myths about Medicare and the Health Care Reform Law are repeated so often that it is difficult for people to know what is true and what is false.  Compound Captive got it wrong on just about all the points in his April 15th post.


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  • tiponeill

    Strange – when Mark Evans was enumerating the conservative/liberal “balance” at TC.com, Compound Captive wasn’t listed - didn’t realize that we had another conservative back.
    I guess they feel they are outnumbered.

    • Carolyn Classen

      Tiponeill, for some reason Compound Captive isn’t listed under the “Politics & Government” section, but under “Life”, yet he is another conservative blogger.  Welcome back to you (I hope).  We need your voice here online.

      • Mark B. Evans

        Sandefer writes a lot about politics and most of his political views are conservative, but he’s not a political blogger.
        Carolyn Classen writes a lot about politics and most of her political views are liberal (judging by what she’s written so far, but I’ve known Jim for 10 years and I’ve only know Carolyn for about 10 months), but she’s not a political blogger.
         

        • http://thechollajumps.com Jim Kelley

          I will be forever grateful to Mark Evans for allowing me to blog here.

  • tiponeill

    As to the issue of Medicare reimbursement rates – it IS a problem which was caused by tying rates to GDP and not the actual cost of medical care.
    It also predates Obama and healthcare reform and is something that the Democrats want to fix – as is shown by the  the Medicare Improvements for Patients and Providers Act of 2008, H.R 6331 sponsored by Charles Rangel and passed bi-partisanly over Bush’s veto.

  • vegasallen

    Well, no misinformation here.

    My neighbor has prostate cancer which they think has metastasized to the bone. Obviously a very serious condition where the quality of care can mean life or death.

    He wanted to go to the Cancer Treatment Center Of America in Phoenix and was told they wouldn’t see him because his only insurance is Medicare.

    As reimbursements to medical professionals decline, it’s inevitable that stories such as this will become commonplace.

    • medicareblogger

      If your friend only has Medicare and no Medicare supplement,  he will be responsible for 20% of the cost of his care, which can amount to $10,000 or much more.  This may be why the Cancer Center of America would not accept him.  Having only Medicare is not a good idea because Part B of Medicare covers only 80% of the cost of care.  Chemo and radiation treatment for cancer come under Part B., as do all doctor visits and labs. So his cancer treatment bills might have added up to tens of thousands of dollars.
      People who have only Medicare (and no supplement) run the risk of going bankrupt if they are diagnosed with cancer or a chronic illness.
      I know a man who was told by University Medical Center that the transplant he needed could not happen if he had only  Medicare – because his 20% co-insurance would be too much for him to pay.  This person enrolled in a Medicare Advantage plan and was able to get the transplant because the Advantage plan limited his co-insurance. The hospital knew it would get paid by the Advantage company for the expensive treatment, so they agreed to the transplant operation.
      Medicare may not have been the issue for the Cancer Center of America.  Your friend not having a supplement might have been the reason he was refused treatment.

  • medicareblogger

    I just called the Cancer Centers of America 800 number and I asked if they accept Medicare.  I was told that they do.  I was asked by the representative if I have a Medicare Supplement “because Medicare will only cover 80% of the bill”.

  • vegasallen

    medicareblogger –Thanks for the information. Actually the 20% up to $10,000 is what I expected but I’m relating the story that was told to me. I’ll see my neighbor tomorrow and see if he understands or possibly was given incorrect information by an operator.

    • medicareblogger

      If your neighbor doesn’t have a Medicare supplement, Blue Cross Blue Shield of Arizona will take people with pre-existing conditions.  They charge a higher rate, but your neighbor can get into a plan F or the new Plan N (in June) and get the 20% co-insurance covered.  BCBSAZ doesn’t have a waiting period for pre-existing conditions, so he would get coverage for his medical expenses right away.  If he applies now, he would be covered as of May 1.

  • http://pointmantucson.yuku.com/ mike_brewer

    I am a 100% Disabled Veteran/Permanent and Total. I have both Medicare A&B for experiences where I cannot get to a VA Hospital, or for second opinions and alternative care.
    I have used Medicare for all three of those needs, and both myself and the Doctors of choice have been content with the service and the level of care.