Here We Go Again! Cuts to Medicare/TRICARE Physician Payments Begin January 1 Unless Congress Acts

Here We Go Again! Cuts to Medicare/TRICARE Physician Payments Begin January 1 Unless Congress ActsAttention TRICARE beneficiaries! In two weeks, doctors will face a 26.5% payment cut for care they provide to Medicare and TRICARE patients. The National Military Family Association believes these impending cuts will directly affect military families’ access to timely care because physicians may decide to no longer care for their existing Medicare or TRICARE patients or accept new ones.

Getting a so-called “Doc Fix,” which would end scheduled cuts in Medicare reimbursement rates, is a recurring issue. Congress temporarily stopped the scheduled payment cuts in February 2012 as part of the Middle Class Tax Relief and Job Creation Act of 2012  (P.L. 112-96). Unfortunately, that fix is due to expire on January 1, 2013, which means that without further Congressional action the 26.5% physician payment cut will go into effect. The timing of the expiration also means the issue has been caught up in the negotiations over the pending fiscal cliff. This makes fixing it that more difficult.

By law, TRICARE reimbursement rates must follow the Medicare reimbursement rules. The law does permit TRICARE to make exceptions if necessary to ensure an adequate network of providers or to eliminate a situation of severely impaired access to care. But, the process of making those adjustments can take time and may happen only after TRICARE officials receive enough reports that military families aren’t finding the care they need.

Our research, Views from the Homefront, demonstrated the need for mental health services for military spouses and children. Our military families already experience difficulty gaining access to mental health care in many communities. We cannot afford to lose any mental health providers. After 11+ years of war, the military must be growing our access to mental health care rather than decreasing it.

We’ve been monitoring this issue and raising concerns about the impact not fixing the rates could have on military families. We encourage military families to contact Members of Congress (House and Senate) and tell them how these cuts can affect access to the health care they need. Ask Congress to implement a permanent fix.

What do you think about these potential cuts? Will your family be affected?

Joyce RaezerPosted by Joyce Raezer, Executive Director at the National Military Family Association

3 responses to “Here We Go Again! Cuts to Medicare/TRICARE Physician Payments Begin January 1 Unless Congress Acts

  1. Such an important issue, and I’m going to post this on the Facebook page for “FLAT DADDY,” the documentary I co-directed about military families and the impact of deployment. I noticed that the link for contacting House Representatives doesn’t work, however. Can this be fixed? I’m hoping readers will follow through immediately if this grabs their attention. Thank you so much.

  2. Pingback: One toe over the edge: the Fiscal Cliff and military families | Branching Out

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