HOUSTON, Texas (KTRK) — Changes could be coming to how the federal government funds Medicare, a program for Americans with disabilities and those aged 65 and older.<\/p>\n
Doctors said the changes will mean many more office visits for you.<\/p>\n
Walk into Balance Family Medicine in Katy, and the first thing patients see is a warning.<\/p>\n
A sign that says, “Proposed Medicare Changes Could Affect Your Access to Care.”<\/p>\n
“Me being a gunshot victim and with a spinal cord injury, I go through a lot of complications,” explained patient Mylo Johnson, who is on Medicare.<\/p>\n
It’s a scenario most of us are familiar with.<\/p>\n
You walk into your doctor’s office, and the check-up begins.<\/p>\n
If there’s a small, quick procedure, separate from the check-up, that needs to be done, you can often get that on the same day and then head home.<\/p>\n
If this proposed change goes through, Medicare wouldn’t fully reimburse doctors for both the check-up and the procedure on the same day.<\/p>\n
“So, things like bloodwork, vaccines, earwax removals, your toenails being clipped at the doctor, an EKG if you’re here for chest pain. A UTI, you can’t get your urine run; if you think you’re pregnant, come back tomorrow for your pregnancy test,” Dr. Felicity Mack, General Practitioner at Balance Family Medicine and a Harris County Medical Society Board Member, explained.<\/p>\n
Dr. Sunaina Likhari is a dermatologist in Sugar Land. She said the change would mean multiple appointments for procedures like mole screening and wart removal.<\/p>\n
“Whenever my parents ask me, ‘Hey, can we remove this today?’ I tell them, ‘Yes, right now, but next year, that may not be the case,'” Dr. Likhari said.<\/p>\n
Dr. Likhari said the change would make her practice less efficient when it comes to both time and money.<\/p>\n
Medicare would only reimburse doctors for 50% of the cost of same-day procedures.<\/p>\n
“Most practices operate at more than a 50% overhead,” she explained. “So, it’s going to be unsustainable if you still have to pay your staff and buy your supplies. That procedure would be reimbursed completely differently if it were done another day. So, it’s hard to justify.”<\/p>\n
The Medicare proposal doesn’t give an explanation for the proposed change, but does mention streamlining payments and asks the public for feedback.<\/p>\n
Patients tell us this change will narrow their options.<\/p>\n
“I don’t drive, and I live in Wharton, which is approximately an hour and 15 minutes from here,” patient Vickie Jetelina said. “If I have to come see her for one thing at a time, that means I have to pay somebody to bring me in every time I come in.”<\/p>\n
“It’s very frustrating, and it makes you feel like the people who make these changes don’t really care about us,” Johnson added.<\/p>\n
“It really does impact everyone because Medicare is kind of the standard, so once Medicare says, ‘ Hey, we’re going to start doing this, commercial insurance follows suit,'” Dr. Mack said.<\/p>\n
A similar proposal was canceled in 2019 after criticism from physician and patient advocacy groups.<\/p>\n