Legislation Would Allow Medicare-Eligible Elders to Negotiate Private Contracts with Doctors

Medicare eligible-elders would be able to negotiate private contracts with doctors under new legislation proposed by Senator Lisa Murkowski.

Murkowski says Senate Bill 1042 called the Medicare Patient Empowerment Act would allow patients to see any physician they choose, even if that doctor has opted out of taking Medicare patients.

Currently elders find that increasing numbers of doctors refuse to see them once they turn 65 and here’s why. When a person who has private insurance turns 65, Medicare automatically becomes the primary insurance, whether you want it to or not and private insurance becomes secondary. If the newly minted Medicare recipient can find a physician who will see them, Medicare sets a rate of reimbursement based on what they deem reasonable. If the doctor says the office visit is 100 dollars, Medicare may say, we think that visit is worth 50 and we’ll pay roughly 80% of that 50. Then the secondary insurance pays the remaining 20% of the 50 dollars, leaving the physician on the hook for the rest of their overhead. Under Murkowski’s plan, a person can enter into a contract, negotiate the total fee amount with a doctor and pay out of pocket, what Medicare and secondary insurance doesn’t pick up. Murkowski says right now, it’s illegal for doctors to negotiate lower fees with patients.

Murkowski says that hurts seniors who have paid in to Medicare for years and should be able to access it. Under her plan, doctors would legally be able to negotiate the fee above the amount allowed by Medicare.

James Jordan is the executive director of the Alaska State Medical Association. He says Anchorage is a good example of a growing problem. The city’s population is rapidly aging and by 2020, he says the Medicare beneficiary population is expected to double.

There are countless stories in Alaska and especially Anchorage where seniors have been turned away by 50 or more doctors when they become Medicare recipients. Murkowski says this is not wholesale reform of Medicare but she says for too many seniors in Alaska, they’re getting 100% of nothing right now. She says the lowest income people who are Medicaid eligible would not benefit from this legislation. But the people in the middle are the ones that AARP Alaska spokeswoman Ann Seacrest is concerned with.

Seacrest says bottom line, the reimbursement system needs a fix. She says this is a band aid.

The American Medical Association is endorsing Murkowski’s Medicare Patient Empowerment Act. A companion bill is in the U.S. House sponsored by Republican Congressman Carl Rosen, a doctor from Georgia.

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Lori Townsend is the News Director for the Alaska Public Radio Network. She got her start in broadcasting at the age of 11 as the park announcer of the fast pitch baseball games in Deer Park, Wisconsin. She has worked in print and broadcast journalism for more than 24 years. She was the co-founder and former Editor of Northern Aspects, a magazine featuring northern Wisconsin writers and artists. She worked for 7 years at tribal station WOJB on the Lac Courte Oreilles Ojibway Reservation in Wisconsin, first as an on-air programmer and special projects producer and eventually News Director. In 1997 she co-hosted a continuing Saturday afternoon public affairs talk program on station KSTP in St. Paul, Minnesota. Radio brought her to Alaska where she worked as a broadcast trainer for Native fellowship students at Koahnic Broadcasting. Following her work there, she helped co-found the non-profit broadcast company Native Voice Communications. NVC created the award-winning Independent Native News as well as producing many other documentaries and productions. Townsend was NVC’s technical trainer and assistant producer of INN. Through her freelance work, she has produced news and feature stories nationally and internationally for Independent Native News, National Native News, NPR , Pacifica, Monitor Radio, Radio Netherlands and AIROS. Her print work and interviews have been published in News from Indian Country, Yakama Nation Review and other publications. Ms. Townsend has also worked as a broadcast trainer for the Native American Journalist’s Association and with NPR’s Doug Mitchell and as a freelance editor. Townsend is the recipient of numerous awards for her work from the Alaska Press Club, the Native American Journalists Association and a gold and a silver reel award from the National Federation of Community Broadcasters. Townsend was the recipient of a Fellowship at the Metcalf Institute for Marine and Environmental Reporting in Rhode Island as well as a fellowship at the Knight Digital Media Center in Berkeley. She is an avid reader, a rabid gardener and counts water skiing, training horses, diving and a welding certification among her past and current interests. ltownsend (at) alaskapublic (dot) org  |  907.550.8452 | About Lori