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Medicare SGR Reduction
With regard to Medicare, is your practice currently classified as participating
or non-participating?
Response Response
Answer Options
Percent Count
Participating 97.7% 512
Non-participating 2.3% 12
answered question 524
skipped question 0
With regard to Medicare, is your practice currently classified as
participating or non-participating?
Participating
Non-participating
Medicare SGR Reduction
Considering Medicare, if the 21.3% reduction goes (and stays) into effect, how
would that affect your policies regarding Medicare patients?
Response Response
Answer Options
Percent Count
It will not affect our policies 31.1% 163
We would reduce the number of Medicare patients we 30.9% 162
We would increase the number of Medicare patients we 1.3% 7
We would likely stop seeing Medicare patients 10.9% 57
We will continue to see existing patients but will not 25.8% 135
Other (please specify) 87
answered question 524
skipped question 0
Other (please
Number Response Date
specify)
1 Apr 1, 2010 2:04 AM Being non-par with the expected decrease in access at other practices
2 Apr 1, 2010 2:12 AM we would have to send patients to the hopstial for infusion services
3 Apr 1, 2010 2:26 AM we might just 'opt out' all together
4 Apr 1, 2010 2:32 AM We are a children's hospital practice and not affected directly by Medi
5 Apr 1, 2010 2:45 AM Medicare is currently 30% of our volume, we couldn't stop or limit
6 Apr 1, 2010 3:15 AM We are hospital based pathologists - we have to take all comers - it w
7 Apr 1, 2010 3:22 AM Current policy is to continue to see existing patients but not accept ne
8 Apr 1, 2010 3:22 AM and we have also discussed only having the PA's see medicare patien
9 Apr 1, 2010 9:53 AM my physicians are divided on this - some want to stop seeing Medicar
10 Apr 1, 2010 11:11 AM restructure HMP/PPO contracts
11 Apr 1, 2010 12:07 PM OB/GYN specialty; very little Medicare business. Also, for our specialty
12 Apr 1, 2010 12:11 PM Dump all MA Plans
13 Apr 1, 2010 12:12 PM Re-evaluating our policy feverishly.
14 Apr 1, 2010 12:14 PM and as current patients age into medicare
15 Apr 1, 2010 12:20 PM WE would most likely start by going "non-par" and hold the patient re
16 Apr 1, 2010 12:27 PM We are a poor inner city hospital, that takes the charity patients. Med
17 Apr 1, 2010 12:39 PM We will close our dorrs. The problem is that most other insurance con
18 Apr 1, 2010 12:50 PM We see medicaid patients, so our reimbursement from our Medicaid m
19 Apr 1, 2010 12:51 PM Our practice is 48% Medicare not sure how reducing or stop seeing M
20 Apr 1, 2010 12:55 PM We will stop seeing TRADITIONAL Medicare patients, but will continue
21 Apr 1, 2010 12:58 PM Services and staff will have to be cut so the scheduling of necessary t
22 Apr 1, 2010 12:58 PM We will only see Mediare patients where reimbursement covers our to
23 Apr 1, 2010 12:59 PM Not Sure - Individual practice decision
24 Apr 1, 2010 1:03 PM We are an oncology clinic. We will still see Medicare patients but will s
25 Apr 1, 2010 1:11 PM As of now
26 Apr 1, 2010 1:11 PM Possibly opt out or go non-par also
27 Apr 1, 2010 1:12 PM Our cost multiplier per RVU is well below Medicare payment per RVU.
28 Apr 1, 2010 1:21 PM Allow individual practitioners discretion
29 Apr 1, 2010 1:23 PM We will seek being whole with the local hospital
30 Apr 1, 2010 1:23 PM We may move to non-participating, but have not yet decided as an or
31 Apr 1, 2010 1:24 PM We are pediatrics and all managed medicaid plans follow the medicar
32 Apr 1, 2010 1:28 PM We will not accept new patients covered under original Medicare and
33 Apr 1, 2010 1:33 PM We're really not sure how this would affect our practice at this point.
34 Apr 1, 2010 1:36 PM As anesthesiologists, we are unable to close or limit our practice to M
35 Apr 1, 2010 1:39 PM Many of our services will be discontinued. (infusions done in the office
36 Apr 1, 2010 1:43 PM IF PHYSICIANS IN OUR COMMUNITY DO NOT SEE MEDICARE PATIEN
37 Apr 1, 2010 1:48 PM We are a hospital based service (anesthesiology), so we would be imp
38 Apr 1, 2010 1:48 PM We will not address all of a Medicare patient's issues in one visit. The
39 Apr 1, 2010 1:59 PM As an academic medical center and level one trauma center we will n
40 Apr 1, 2010 2:04 PM Unsure
41 Apr 1, 2010 2:07 PM We are gastroenterology practice and our patient base is the older po
42 Apr 1, 2010 2:07 PM If this is going to pass, it will not evev cover our expences for the faci
43 Apr 1, 2010 2:22 PM Nephrology Practice - End Stage Renal Disease is a Medicare covered
44 Apr 1, 2010 2:27 PM This would be very difficult for our practice, as we are internal medici
45 Apr 1, 2010 2:28 PM We currently do not see new patients who have Medicare coverage
46 Apr 1, 2010 2:31 PM We are a rural health clinc. It is my understanding it will not effect ou
47 Apr 1, 2010 2:35 PM We will continue to see existing patients and reduce the number of ne
48 Apr 1, 2010 2:43 PM We have not fully developed a policy at this time. Medicare makes up
49 Apr 1, 2010 3:01 PM We may also only continue seeing active Medicar patients, those that
50 Apr 1, 2010 3:02 PM We are hospitalists-cannot pick and choose patients
51 Apr 1, 2010 3:02 PM The possibility of reducing the number of Medicare patients being see
52 Apr 1, 2010 3:08 PM initially we will significantly reduce the number of medicare patients w
53 Apr 1, 2010 3:17 PM ALSO MAY NOT ACCEPT NEW MEDICARE PATIENTS
54 Apr 1, 2010 3:22 PM Currently the practice is evaluating maintaining our relationship with M
55 Apr 1, 2010 3:48 PM go to non-participating in Medicare program
56 Apr 1, 2010 3:55 PM However, we are a hospitalist practice, so our patients are picked up
57 Apr 1, 2010 3:56 PM It would be a tremendous challenge since we are the primary clinic in
58 Apr 1, 2010 3:59 PM We are owned by a NFP health system, so could not stop seeing Med
59 Apr 1, 2010 4:07 PM We will have to cut our overhead, like employees working less hours,
60 Apr 1, 2010 4:13 PM We are hospitalists. We must see Medicare patients.
61 Apr 1, 2010 4:19 PM We are general surgeons who take a bunch of E.R. call so we will hav
62 Apr 1, 2010 4:28 PM Not for profit foundation model. We will continue to see Medicare and
63 Apr 1, 2010 4:32 PM We would continue until it became financially impossible to continue.
64 Apr 1, 2010 4:33 PM We are hospitalist and have no choose.
65 Apr 1, 2010 5:07 PM A decision has yet to be made.
66 Apr 1, 2010 5:07 PM with the exception of seeing MC PTs for EMG NCS
67 Apr 1, 2010 5:53 PM We have given notice that we are out of Medicare.
68 Apr 1, 2010 6:00 PM We are a secondary provider or Radiology services so we have to see
69 Apr 1, 2010 6:33 PM Our practice is 100% geriatric, so we have no choice but to continue
70 Apr 1, 2010 6:57 PM We would look to opt out Oct 2010
71 Apr 1, 2010 7:06 PM I wok in a hospital.
72 Apr 1, 2010 7:11 PM WE MAY OPT OUT OF MEDICARE ASSIGNMENT
73 Apr 1, 2010 7:16 PM Two of our physicians will opt out and charge those Medicare patients
74 Apr 1, 2010 7:20 PM would likely become a non-participating provider
75 Apr 1, 2010 7:57 PM However, one of our senior partners will likely limit access to new Med
76 Apr 1, 2010 8:08 PM We are Pediatrics - no Medicare - but it will affect our other contracts
77 Apr 1, 2010 8:50 PM Because we are the only orthopaedic surgery practice in our rural are
78 Apr 1, 2010 10:05 PM We will have to stop seeing new medicare patients and fire staff mem
79 Apr 1, 2010 10:52 PM Since we are hospital based, we must accept all Medicare patients tha
80 Apr 2, 2010 1:40 AM 50% plus is Medicare - we cannot live without it.
81 Apr 2, 2010 11:15 AM We may stop taking Medicaid patients, as we will no longer be able to
82 Apr 2, 2010 12:57 PM no new medicare patients. I'm thinking about giving the White HOus
83 Apr 2, 2010 1:52 PM Several physicians are considering actually stopping to participate in M
84 Apr 2, 2010 3:03 PM My clinics are owned by a hospital system and we have been only one
85 Apr 2, 2010 4:41 PM We are an RHC so we will have limited effect with our Parb B services
86 Apr 2, 2010 5:36 PM Some physicians have stated they will not see new Medicare patients.
87 Apr 3, 2010 6:27 PM OTHER LARGE INSURANCE COMPANIES NOW ARE ALREADY PAYING
Considering Medicare, if the 21.3% reduction goes (and stays) into
effect, how would that affect your policies regarding Medicare
patients?
It will not affect our policies
We would reduce the number of
Medicare patients we see
We would increase the number of
Medicare patients we see
We would likely stop seeing
Medicare patients
We will continue to see existing
patients but will not accept new
in access at other practices we would expect to increase our number of Medicare patients (who were not able to access other practices).
Medicare patients
stial for infusion services
ot affected directly by Medicare.
we couldn't stop or limit
ve to take all comers - it will greatly impact MD revenue.
patients but not accept new Medicare patients. Reduction will not change this policy.
e PA's see medicare patients
ant to stop seeing Medicare patients if the cut goes through - at least one is of the opinion that any revenue is better than none
ness. Also, for our specialty, the impact is not as drastic. Not quire a 21% decrease.
par" and hold the patient responsible for difference, up front.
s the charity patients. Medicare cuts will severely impact our financials, even though we have only 12 %.
at most other insurance contracts base their reimbursement on the Medicare Fee Schedule.
ement from our Medicaid managed care would be affected greatly.
w reducing or stop seeing MC patients would help us
e patients, but will continue seeing Medicare Advantage patients
e scheduling of necessary tests will be delayed and appointments to see our physicians will not be as prompt as they are now delaying office
imbursement covers our total expenses, Drug cost & overhead, and provided a margin. Otherwise, we will send to the hospital for treatmen
Medicare patients but will shift more treatments to the hospital. As it stands today, about 65% of our Medicare patients are treated at the h
edicare payment per RVU. Medicare is 31% of the payer mix.
ve not yet decided as an organization.
d plans follow the medicare fee schedule. It will hurt our practice immensly as will the consult code deletion since we are mostly peds subs
nder original Medicare and will try to convert our existing patients to one of the MA plans that pays us substantially more than original Medic
our practice at this point. We're still hoping it doesn't happen.
e or limit our practice to Medicare. Being at a teaching hospital, I expect our volume of Medicare will stay the same or increase as people ar
infusions done in the office)
OT SEE MEDICARE PATIENTS, THIS WILL CERTAINLY OPEN THE OPPORTUNITY FOR REALLY LARGE ACO's TO MOVE IN. WHILE I WOULD
ology), so we would be impacxted tot he degree that surgeons cut back their Medicare volume/access
nt's issues in one visit. They would have to return for additional visit(s). We could not possibly keep our heads above water without genera
ne trauma center we will not be able to stop seeing Medicare patients
patient base is the older population
er our expences for the facility, I cannot say how long we could do this and still stay afloat!!!
ease is a Medicare covered illness - Medicare is the majority of our income
, as we are internal medicine and just merged with another I.M. practice to help weather the storms. However; our area overall has seen lo
have Medicare coverage
tanding it will not effect our payments at this time
nd reduce the number of new Medicare patients we accept
s time. Medicare makes up about 55% of our patient base in our cardiology practice.
edicar patients, those that have been seen within the last year and terminate established but non active fromt the practice.
Medicare patients being seen is currently being considered by our Board of Directors. No final decision yet.
mber of medicare patients we see
ning our relationship with Medicare patients, accepting new and retaining current, until we can assess excess capacity and impact of primar
our patients are picked up by ER call or from other physician offices. If we were a regular practice we would probably chose to continue to
we are the primary clinic in our region and Medicare patients make up 47% of our business. We have talked about not seeing them, howev
could not stop seeing Medicare patients, but would need to limit them as a % of our business
loyees working less hours, etc.
h of E.R. call so we will have to see Medicare patients. We cannot change to non-par because we most likely will not be able to collect paym
ontinue to see Medicare and try to make up the difference somewhere else. Cost shifting continues - a very steep hidden tax!
lly impossible to continue. This may not take long since 35% of our patients are medicare.
services so we have to see Medicare patients.
no choice but to continue seeing Medicare and PFFS covered patients.
ge those Medicare patients who choose thier services cash.
ely limit access to new Medicare patients.
l affect our other contracts that are based on the Medicare fee schedule.
ry practice in our rural area, we would continue.Our income would drop as we have about 33%of our practice is made of Medicare insured
patients and fire staff members
pt all Medicare patients that present. However, we do not base any non government insurance contracts on a percentage of Medicare rates
we will no longer be able to afford to lose money on this patient class.
out giving the White HOuse switchboard pone number for patients to call. (202-456-1414)
stopping to participate in Medicare all together
and we have been only ones accepting new MC pts for ~5yrs.
ct with our Parb B services.
see new Medicare patients.
OW ARE ALREADY PAYING LESS THAN MEDICARE
o access other practices).
better than none
they are now delaying office visits and forcing patients to the primary or ER, wait times will increase and as a result we will probably see few
to the hospital for treatment.
patients are treated at the hospital due to Medicare reimbursement not covering the cost of the drugs let alone overhead.
ce we are mostly peds subspecialists.
ally more than original Medicare. We've lost the window for 2010 but may have to give patients an either or ultimatum for 2011.
me or increase as people are less likely to find care in other settings.
MOVE IN. WHILE I WOULD LIKE TO SAY WE WILL STOP SEEING MEDICARE - THAT IS NOT A VERY GOOD ALTERNATIVE.
above water without generating more revenue through return visits.
our area overall has seen lower numbers in patient visits this first quarter, and we just started two new physicians over the past year. Our a
pacity and impact of primary care incentives.
obably chose to continue to see exisiting patients, but not accept new Medicare patiens.
out not seeing them, however nobody else in town would see them either.
not be able to collect payment from patients seen in the E.R.
p hidden tax!
made of Medicare insured
ercentage of Medicare rates.
sult we will probably see fewer medicare patients. Some physicians may become nonpar and we would have a dedicated medicare physician
matum for 2011.
ns over the past year. Our area has a high population of retirees, and our patient population is approx. 60% Medicare. We do not feel like w
edicated medicare physician when his schedule is full then the practice is closed.
dicare. We do not feel like we have much choice. There are not a lot of young healthy patients standing at the door to get in at this time! W
oor to get in at this time! What to do? Good question?
Medicare SGR Reduction
If you are a participating practice, how likely would you be to change your
status to non-participating?
Response Response
Answer Options
Percent Count
Very Likely 15.6% 82
Somewhat Likely 15.5% 81
Not Sure 23.3% 122
Somewhat Unlikely 18.7% 98
Very Unlikely 26.9% 141
answered question 524
skipped question 0
If you are a participating practice, how likely would you be to change
your status to non-participating?
Very Likely
Somewhat Likely
Not Sure
Somewhat Unlikely
Very Unlikely
Medicare SGR Reduction
Approximately what percent of your revenue is tied to managed care contracts
that use the Medicare Fee Schedule (not RBRVS) as a basis for their fees?
Response Response
Answer Options
Percent Count
Less than 10% 12.2% 64
10% to 20% 11.3% 59
20% - 30% 12.2% 64
30% to 40% 13.5% 71
40% to 50% 6.1% 32
50% to 60% 8.8% 46
60% to 70% 8.4% 44
70% to 80% 9.5% 50
80% to 90% 7.6% 40
90% to 100% 6.3% 33
Don't Know 4.0% 21
answered question 524
skipped question 0
Approximately what percent of your revenue is tied to managed care
contracts that use the Medicare Fee Schedule (not RBRVS) as a basis
for their fees?
Less than 10%
10% to 20%
20%
30% to 40%
40% to 50%
50% to 60%
60% to 70%
70% to 80%
80% to 90%
90% to 100%
Don't Know
managed care
RVS) as a basis
Less than 10%
10% to 20%
20% - 30%
30% to 40%
40% to 50%
50% to 60%
60% to 70%
70% to 80%
80% to 90%
90% to 100%
Don't Know
Medicare SGR Reduction
Considering your managed care contracts that are tied only to the Medicare
Fee Schedule amount (not RBRVS), how likely would you be to terminate
Response Response
Answer Options
Percent Count
Very Likely 32.1% 168
Somewhat Likely 34.7% 182
Not Sure 17.6% 92
Somewhat Unlikely 8.0% 42
Very Unlikely 7.6% 40
answered question 524
skipped question 0
Considering your managed care contracts that are tied only to the
Medicare Fee Schedule amount (not RBRVS), how likely would you
be to terminate contracts with payers that are not willing to
renegotiate the 21.3% reduction in fees?
Very Likely
Somewhat Likely
Not Sure
Somewhat Unlikely
Very Unlikely
Medicare SGR Reduction
Considering your managed care contracts that are tied only to the Medicare
Fee Schedule amount (not RBRVS), how likely would you be to change your
Response Response
Answer Options
Percent Count
Very Likely 34.0% 178
Somewhat Likely 34.7% 182
Not Sure 17.2% 90
Somewhat Unlikely 6.7% 35
Very Unlikely 7.4% 39
answered question 524
skipped question 0
Considering your managed care contracts that are tied only to the
Medicare Fee Schedule amount (not RBRVS), how likely would you be to
change your status from in-network to out-of-network with payers that
are not willing to renegotiate the 21.3% reduction
Very Likely
Somewhat Likely
Not Sure
Somewhat Unlikely
Very Unlikely
Medicare SGR Reduction
Do you believe that the new Medicare conversion factor of 28.4 is greater
than, equal to or below your current cost per RVU?
Response Response
Answer Options
Percent Count
The new Conversion Factor is higher than my cost per 5.5% 29
The new Conversion Factor is less than my cost per 51.5% 270
The new Conversion Factor is the same as my cost per 2.7% 14
I actually don't know my cost per RVU 40.3% 211
answered question 524
skipped question 0
Do you believe that the new Medicare conversion factor of 28.4 is
greater than, equal to or below your current cost per RVU?
The new Conversion Factor is higher
than my cost per RVU
The new Conversion Factor is less
than my cost per RVU
The new Conversion Factor is the
same as my cost per RVU
I actually don't know my cost per
RVU
Medicare SGR Reduction
Any message you want to give to CMS or you payers?
Response
Answer Options
Count
173
answered question 173
skipped question 351
Response
Number Response Date
Text
1 Apr 1, 2010 2:01 AM I am considering changing my career to law.
2 Apr 1, 2010 2:04 AM We do not participate directly with managed care contracts or Medica
3 Apr 1, 2010 2:11 AM We cannot continue to get the technology that we have purchased in
4 Apr 1, 2010 2:12 AM stop holding providers hostage with personal partisan policies. we gi
5 Apr 1, 2010 2:22 AM Stand alone practices cannot or will not survive which will put Medicar
6 Apr 1, 2010 2:26 AM CMS is holding claims until SRG is extended again, buys time but is no
7 Apr 1, 2010 2:28 AM We will likely reduce staff FTEs by 10% and reduce staff wages acros
8 Apr 1, 2010 2:32 AM I feel that it is next to impossible for anyone to accept a 21% pay dec
9 Apr 1, 2010 2:42 AM Patient access will be a huge issue for our senior population if this cut
10 Apr 1, 2010 2:45 AM Physicians groups accross the country will ulimately be a part of a larg
11 Apr 1, 2010 2:45 AM Let's negotiate a fair reimbursement for services and products deliver
12 Apr 1, 2010 4:03 AM How can CMS expect physicians to deliver quality care, report PQRI a
13 Apr 1, 2010 4:38 AM Fix the SGR. Do not make this drastic cut.
14 Apr 1, 2010 4:42 AM May we reduce your revenue by 21.3% tomorrow?
15 Apr 1, 2010 5:12 AM Cannot accept 21.3% reduction. We need to get rid of the budget neu
16 Apr 1, 2010 11:11 AM Get with the program and pull your head out of the sand, or you will l
17 Apr 1, 2010 12:04 PM The opposite effect of what you desire to achieve will be the outcome
18 Apr 1, 2010 12:04 PM we would most likely continue to see Medicare pts, we have a good p
19 Apr 1, 2010 12:07 PM CMS does not care. For payers, the right thing would be to freeze the
20 Apr 1, 2010 12:07 PM We are 16 provider busy practice in multispeciality seeing over 300 pt
21 Apr 1, 2010 12:07 PM Incentivise your providers to care for the consumers by utilizing good
22 Apr 1, 2010 12:11 PM How about decreasing your administrative overhead the same percen
23 Apr 1, 2010 12:11 PM Yes but it probably would not be professional. CMS is less the issue th
24 Apr 1, 2010 12:12 PM As the only community hospital in our county, this will have a disastro
25 Apr 1, 2010 12:13 PM Stop this madness....
26 Apr 1, 2010 12:14 PM if you increase medicare rtates, then more physicians will accept new
27 Apr 1, 2010 12:14 PM Medical practices have been diligent in reducing costs and have contin
28 Apr 1, 2010 12:17 PM I can't but it in the survey
29 Apr 1, 2010 12:23 PM In question #4 we are tied to the Medicare fee schedule but an older
30 Apr 1, 2010 12:26 PM If the cut goes into effect, the battle lines are drawn.
31 Apr 1, 2010 12:27 PM Restore the cuts, restore faith in the system. Otherwise there will be
32 Apr 1, 2010 12:30 PM Our hands are tied. 54% of our patients are Medicare (cardiology). 3
33 Apr 1, 2010 12:35 PM We will be forced to limit the amount of Medicare patient we will be a
34 Apr 1, 2010 12:37 PM Even without the possible 21.3% reduction, our practice is struggling
35 Apr 1, 2010 12:39 PM We will be out of business...
36 Apr 1, 2010 12:45 PM Come up with a Medicare reimbursement formula that is fair and reas
37 Apr 1, 2010 12:46 PM Please consider the impact this will have on academic primary care in
38 Apr 1, 2010 12:50 PM Get a real objective viewpoint as to the far reaching affect to the US c
39 Apr 1, 2010 12:58 PM We can not continue to offer the excellent care and attention that we
40 Apr 1, 2010 12:58 PM Access to care for Medicare patients will become more difficult, and c
41 Apr 1, 2010 12:59 PM Providers in Rural Communities are at a great disadvantage due to lar
42 Apr 1, 2010 1:01 PM Stop hurting medical practices. We give up 50% of our office charges
43 Apr 1, 2010 1:09 PM Wake up and fix the SGR mess!!
44 Apr 1, 2010 1:11 PM correct the payment methodology now
45 Apr 1, 2010 1:11 PM Leave us alone!
46 Apr 1, 2010 1:12 PM Any managed care contract that does not tie to a static Medicare base
47 Apr 1, 2010 1:14 PM It is hard to answer these questions. If the SGR does go into effect, w
48 Apr 1, 2010 1:22 PM Please take into consideration the cost of supplies is increasing, the co
49 Apr 1, 2010 1:23 PM Kill the SGR!
50 Apr 1, 2010 1:24 PM If 30,000,000 people will get health insurance in the presidents plan w
51 Apr 1, 2010 1:27 PM As you increase the number of insured, scaring away doctors by cuttin
52 Apr 1, 2010 1:28 PM One question you didn't ask is what % of your managed care contrac
53 Apr 1, 2010 1:28 PM Prepare yourselves for a Senior Citizens revolt when they no longer ha
54 Apr 1, 2010 1:43 PM HOPE YOU TAKE A 21% CUT IN PAY AND BENEFITS FOR YOU JOB IN
55 Apr 1, 2010 1:46 PM This can not happen!
56 Apr 1, 2010 1:49 PM Due to the reduction in reimbursement we will no longer be able to p
57 Apr 1, 2010 1:54 PM Concentrate more on taking waste out of the current system in a conc
58 Apr 1, 2010 1:56 PM Implementation of the cut would result not only in limiting the amoun
59 Apr 1, 2010 1:59 PM Note - as a practice of Nephrologists we cannot opt out of Medicare a
60 Apr 1, 2010 2:04 PM They are dis-incentivizing providers to provide care to Medicare patien
61 Apr 1, 2010 2:04 PM We cannot withstand this cut without dramatically changing the level
62 Apr 1, 2010 2:05 PM If this cut stays in effect it will become more and more difficult for pa
63 Apr 1, 2010 2:07 PM Physicians can not continue to take decreases in payments and increa
64 Apr 1, 2010 2:07 PM Everyone will see this trickling effects of this reduction, I am concerne
65 Apr 1, 2010 2:08 PM Access to orthopedic care for this patient class is going to be greatly d
66 Apr 1, 2010 2:08 PM Stabilizing the physician payment system is as essential an issue to he
67 Apr 1, 2010 2:12 PM Get real with your reimbursement model.
68 Apr 1, 2010 2:18 PM Defeat every seated senator and representative. Get new representa
69 Apr 1, 2010 2:19 PM We will reduce care to all Medicare patients, by either limiting access
70 Apr 1, 2010 2:25 PM We live in an area with a high population of Medicare patient and curr
71 Apr 1, 2010 2:27 PM This country will be in grave danger of losing primary care providers,
72 Apr 1, 2010 2:28 PM I am the administrator of a primary care group and there is great con
73 Apr 1, 2010 2:35 PM With the proposed cutbacks, no more CCI edit pairs should be added.
74 Apr 1, 2010 2:40 PM Physicians will not be able to afford to see Medicare patients if they c
75 Apr 1, 2010 2:41 PM We want to be able to keep our doors open and able to pay our empl
76 Apr 1, 2010 2:43 PM This has got to be fixed or no amount of healthcare reform will matte
77 Apr 1, 2010 2:43 PM Stop this insanity. You will start seeing nothing but foreign doctors.
78 Apr 1, 2010 2:52 PM A reduction in our reimbursment would mean we cannot hire new em
79 Apr 1, 2010 2:53 PM Please don't do this to us!!!! Will put us out of business if you do.
80 Apr 1, 2010 2:54 PM Each year our costs go up, however our fee schedules go down. No c
81 Apr 1, 2010 2:55 PM There are so many.... The most important is that we care about our M
82 Apr 1, 2010 3:00 PM Ths cut will have significant reamifications on the provider's ability to
83 Apr 1, 2010 3:01 PM CMS must stabilize the payment system for Medicare patients. Health
84 Apr 1, 2010 3:02 PM This impact would completely change access to care. If you think it is
85 Apr 1, 2010 3:02 PM We have written and called representatives in both the House and the
86 Apr 1, 2010 3:07 PM Thanks for making us possibly close our doors.
87 Apr 1, 2010 3:08 PM The reduction in fees sends a strong statement that our medicare rec
88 Apr 1, 2010 3:08 PM The proper funding has been ongoing for years. We are not making a
89 Apr 1, 2010 3:09 PM Stop playing games with us. Take time to look at the overall picture a
90 Apr 1, 2010 3:15 PM I need to re-do stat
91 Apr 1, 2010 3:17 PM They are fortunate that we are part of a hospital system. Our particip
92 Apr 1, 2010 3:20 PM We have already contacted our CA legislators and asked them to repe
93 Apr 1, 2010 3:20 PM Since the Medicare reimbursement prior to the cut barely met our cos
94 Apr 1, 2010 3:21 PM With our radiologist reading at all our community hospitals, we have n
95 Apr 1, 2010 3:22 PM We do not have any contracts tied to Medicare fee schedule. Might b
96 Apr 1, 2010 3:22 PM We must move off of contracts being tied to Medicare Fee Schedule if
97 Apr 1, 2010 3:24 PM We would strongly consider a fee for service only practice.
98 Apr 1, 2010 3:24 PM Since we are a non-profit organization that is mission driven to treat t
99 Apr 1, 2010 3:37 PM These cuts will further decrease the participating and in-network phys
100 Apr 1, 2010 3:39 PM We will likely integrate with a hospital resulting in significant cost incr
101 Apr 1, 2010 3:40 PM It is time for Congress to stop this insanity and take care of the SGR p
102 Apr 1, 2010 3:41 PM This is not the place to save money. We can not operate at these rate
103 Apr 1, 2010 3:46 PM Do not implement the 21.3% cut.
104 Apr 1, 2010 3:50 PM If the cut becomes permanent, I predict the public will feel it in terms
105 Apr 1, 2010 3:55 PM The cost of care for patients continues to increase not decrease. Yet
106 Apr 1, 2010 3:56 PM Medicare patients, due to the complex medical problems, require mor
107 Apr 1, 2010 4:07 PM Doctors could do other work and may more money. The public is misi
108 Apr 1, 2010 4:09 PM Please fix the Part B payment system and consider equalizing the HOP
109 Apr 1, 2010 4:11 PM I hope CMS realizes that they will bankrupt many practices with the d
110 Apr 1, 2010 4:19 PM The 21.3% cut in reimbursement will force many practices to either li
111 Apr 1, 2010 4:21 PM Our group may decide only to see young healthy patients because rei
112 Apr 1, 2010 4:29 PM In our area our group is a large specialty group and in a semi-retired
113 Apr 1, 2010 4:32 PM Unless this is changed, it is likely that many surgeons currently consid
114 Apr 1, 2010 4:33 PM We are forced to accept this because we are hospitalist however if we
115 Apr 1, 2010 4:44 PM This reduction will dramatically impact primary care providers with a l
116 Apr 1, 2010 4:47 PM Dont think for a second that we will not drop you as a payer! We are
117 Apr 1, 2010 4:55 PM Big business is going to kill small providers
118 Apr 1, 2010 5:04 PM Get a real job and get off the backs of physicians!
119 Apr 1, 2010 5:07 PM If this happens our practice like many others will be rethinking how w
120 Apr 1, 2010 5:13 PM We are an Medical Oncology specific site, with the only full time on sit
121 Apr 1, 2010 5:17 PM Pretty soon you will be able to see the nurse and hope a correct diagn
122 Apr 1, 2010 5:19 PM Message to Congress, next time you take a break without fixing the S
123 Apr 1, 2010 5:20 PM In a practice that has more Medicare patients than any other demogr
124 Apr 1, 2010 5:20 PM Physician compensation is the only place we have any flex without ma
125 Apr 1, 2010 5:21 PM You need to resolve the SRG issue immediately, in order for physician
126 Apr 1, 2010 5:41 PM Base the fee schedule off of RBRVS and not Medicare Fee Schedule.
127 Apr 1, 2010 5:51 PM If SGR is not repealed, our practice that sees 15,000 patients a year w
128 Apr 1, 2010 5:53 PM I am done with Medicare. The only chance they have is to allow bala
129 Apr 1, 2010 5:57 PM We will lay off staff and nursing with this cut. Correct this insane prob
130 Apr 1, 2010 6:23 PM May boycot medicare for a while, "go on strike" or something. May lay
131 Apr 1, 2010 6:25 PM We will be opting out! Which is a huge diservice to our elderly patien
132 Apr 1, 2010 6:32 PM If this does go into effect, it will force some of the older physicians to
133 Apr 1, 2010 6:33 PM GET THIS FIXED NOW. FIX THIS DECADES OLD PROBLEM THAT HAS
134 Apr 1, 2010 6:43 PM With or without the 21.3% reduction, this 7 doctor FP practice is look
135 Apr 1, 2010 6:58 PM We NEED a public option.
136 Apr 1, 2010 7:06 PM What I have to say about BOTH CMS and our payers cannot be printe
137 Apr 1, 2010 7:15 PM I firmly believe that health care costs would be better contained by re
138 Apr 1, 2010 7:16 PM don't do it.
139 Apr 1, 2010 7:17 PM THis is why I NEVER negotiate a contract based on a percentage of M
140 Apr 1, 2010 7:20 PM The patients will be the BIG LOSERS!!!!
141 Apr 1, 2010 7:33 PM if the cut goes through, we will have to lay off some employees becau
142 Apr 1, 2010 7:48 PM It's going to be tough for Medicare patients in Eastern Oklahoma to h
143 Apr 1, 2010 7:57 PM As a result of the SGR reduction, we will be aggressively be cutting ou
144 Apr 1, 2010 8:09 PM By continuing to cut the Medicare program, you are making it much m
145 Apr 1, 2010 8:50 PM * ^ & $ @
146 Apr 1, 2010 9:26 PM There will be no access for Medicare patients.
147 Apr 1, 2010 9:48 PM EMR incentives fail miserably to cover direct costs of implementation.
148 Apr 1, 2010 9:49 PM we are a small internal medicine practice that loves our older patients
149 Apr 1, 2010 10:05 PM Can you destroy health care faster?
150 Apr 1, 2010 10:07 PM Nothing that is printable.
151 Apr 1, 2010 10:23 PM How will the health care service providers survive?
152 Apr 1, 2010 11:52 PM This will have major effect on pt's access.
153 Apr 2, 2010 1:40 AM Doctors will be forced to layoff staff members if the cut is not reverse
154 Apr 2, 2010 12:25 PM This is the only business where you have to try so hard to get paid fo
155 Apr 2, 2010 12:43 PM Frustrated physicians quit practicing or reduce the level of care they p
156 Apr 2, 2010 12:57 PM We in primary care are just getting by as it is. I can not accept any c
157 Apr 2, 2010 1:06 PM This is the only sector in the economy , on a mandated fee schedule,
158 Apr 2, 2010 1:52 PM This will create a drastic problem for MCR patients in finding physician
159 Apr 2, 2010 2:12 PM These changes will financially ruin many physicians who have large M
160 Apr 2, 2010 2:16 PM Please protect our elderly.
161 Apr 2, 2010 3:03 PM Convince Congress to make realistic, permanent changes to CMS paym
162 Apr 2, 2010 4:18 PM Many patients will loose access to health care if something is not done
163 Apr 2, 2010 4:33 PM Don't throw the baby out with the bath water!
164 Apr 2, 2010 5:25 PM As others, we do not think we can continue to see Medicare patients w
165 Apr 2, 2010 6:06 PM Such a drastic payment cut is outrageous. How do you expect doctors
166 Apr 2, 2010 6:13 PM If you want doctors available to care for your medicare patients, cutti
167 Apr 2, 2010 9:08 PM Medicare patients need care, and it is likely they will likely find provide
168 Apr 3, 2010 1:03 AM By cutting Medicare reimbursements you are basically going to gauran
169 Apr 3, 2010 4:35 AM Any reductions in Medicare fees will likely make physicians either quit
170 Apr 3, 2010 11:42 AM It is unfortunate that the opinions of the individuals that ultimately de
171 Apr 3, 2010 1:54 PM Reimbursement for the PCP's are already too low.This reduction will h
172 Apr 3, 2010 6:27 PM IF THIS GOES INTO EFFECT AND OTHER PAYERS ALSO USE THE MED
173 Apr 3, 2010 6:28 PM All other health care facilities and providers except physicians have go
anaged care contracts or Medicare (thus no need to know cost per RVU (also why answered Not Sure for other questions) and these reimbu
ology that we have purchased in the past, or see as many Medicare patients due to the overwhelming burden this reduction would cost us.
personal partisan policies. we give good care and do good work and we should be paid FAIRLY for what we do!
ot survive which will put Medicare Patients at risk if we start losing top quality physicians.
ended again, buys time but is not a solution. It's gotta go or it will trigger a revolt. It's bad enough that Medicare Advantage is about to be
% and reduce staff wages across the board by 5-10%
anyone to accept a 21% pay decrease. How many of the policy makers are willing to take a similar pay cut?
r our senior population if this cut actually takes affect.
y will ulimately be a part of a large multispecialty group or a hospital system. As a result, a ton of employees in physician groups will lose th
for services and products delivered to patients. We cannot maintain current levels of service with current (and increasing) regulations with
eliver quality care, report PQRI and provide services to the population of this country when costs are increasing and payments continue to fa
% tomorrow?
need to get rid of the budget neutral conversion factor.
ead out of the sand, or you will lose many good physicians.
e to achieve will be the outcome of this reduction--a decrease in participating providers, difficulty in locating a physician, financial hardship f
Medicare pts, we have a good percentage of Medicare patients that we have longstanding relationships with...however, a cut such as this w
ight thing would be to freeze the fee schedule for their providers to what they are currently at.
multispeciality seeing over 300 pt everyday & our overheads are close to 75% excluding physician payments, We will be forced to sell our pr
the consumers by utilizing good healthy patient outcomes. Pay them a fair, negotiated rate that adjusts appropriately with inflation over tim
ative overhead the same percentage as physicians are being reimbursed>
essional. CMS is less the issue than Congress and, in my former life as a consultant, we begged practices not to sign any agreement tied to
r county, this will have a disastrous impact to our ability to serve the medical needs of our community and jeapordize the long term viability
more physicians will accept new medicare.that ALONE will save money compared to emergency and urgent care visits, let alone catastrophi
n reducing costs and have continued to provide excellent medical services barely breaking even. With this medicare reduction many medica
dicare fee schedule but an older version (for example 2005).
lines are drawn.
system. Otherwise there will be many, many physicians who will leave Medicare. We are taking less and less from Medicaid, and now this.
ents are Medicare (cardiology). 35% are covered by commercial insurance. We don't have the resources to pursue payment outside of thes
of Medicare patient we will be able to treat per day, if we can not cover our costs to treat them.
uction, our practice is struggling to cover all our operating costs.
ment formula that is fair and reasonable and sustainable, once and for all. These last minute decisions are making it impossible for us to ma
ave on academic primary care in this country - we are already operating on razor-thin margins even in the best of times. We are a volume-
he far reaching affect to the US citizen and their access to quality physicians and quality patient care.
ellent care and attention that we offer our patients now with a 21% pay cut. We have already made cutbacks and run lean due to other cut
will become more difficult, and costs to insurance plans will actually increase since more patients will be receiving care at hospitals.
t a great disadvantage due to large Medicare population in small towns
ve up 50% of our office charges and still accept bogus reasons for additional reimbursement reductions (ERISA law plans vs State DOI Insu
not tie to a static Medicare base year will be terminated. Our practice can not provide quality care to patients if reimbursement is cut by 2
If the SGR does go into effect, we are doomed and would have to make changes that the doctors are not ready to make.
st of supplies is increasing, the cost of keeping our office running, even though we have cut back in areas that we can, remains relatively co
nsurance in the presidents plan with hospital's closing and reimbursements not enough to cover office expenses, and medical school enrollm
d, scaring away doctors by cutting their pay will result in a disaster. We need the best and the brightest doctors, not the cheapest.
% of your managed care contracts are tied to current year Medicare. Most of mine are based on 2004/2006. I have none that are associated
ns revolt when they no longer have access to care!
AND BENEFITS FOR YOU JOB IN WASHINGTON. THIS IS NOT A POLITICAL ISSUE. YOU ARE CUTTIN ACCESS TO MEDICAL CARE AND OR
nt we will no longer be able to provide for patients on your programs. In essence you are creating a culture of hospital over utilization and
ut of the current system in a concentrated, well thought out manner, focusing on prevention, outcomes, and truly fraudulent activities as opp
ult not only in limiting the amount of Medicare patients but would also result in staff layoffs at our clinic. We have a marginal profit at this ti
we cannot opt out of Medicare as most patients on dialysis and transplant patients are on Medicare -
o provide care to Medicare patients; driving them away from participating with commercial insurance; increasing the number of providers lea
dramatically changing the level of service we offer to patients.
e more and more difficult for patients to find physicians to treat them.
ecreases in payments and increases in all the requirements that we are forced to. I have need to increase my Business Office staff by 2 peo
of this reduction, I am concerned as I have wroked hard all my life and do not see anything good coming from this!!!!!!!!!
ient class is going to be greatly diminshed at the very least.
tem is as essential an issue to healthcare reform as increasing access for the uninsured/underinsured. It won't matter that more Americans
esentative. Get new representation that is responsive to the citizens of our country. I'm sorry that the government has put me in a postitio
atients, by either limiting access or limiting time for visits, should these cuts become permanent
tion of Medicare patient and currently have a 50+ percentage of Medicare patients. We will have trouble staying in business should this cut
of losing primary care providers, especially internists!
are group and there is great concern that there will not be enough primary care physicians to address the needs of the people who require
CCI edit pairs should be added. The last addition should be just that, the last.
o see Medicare patients if they can't cover their operating costs. This will lead to an influx of patients with no PCP and hospitals will then ne
s open and able to pay our employees and bills. We do not want to not see our patients but unfortunately we can not do it with these cuts.
t of healthcare reform will matter if patients can"t access the physicians.
ng nothing but foreign doctors. We will not be able to pay the bills with this drastic cuts. There is so much red-tape getting paid as it is. T
ld mean we cannot hire new employees, we have to cut benefits (employee health, disability insurance) we will probably stop seeing new M
us out of business if you do.
our fee schedules go down. No company could stay in business under these conditions. Why are we expected to?
rtant is that we care about our Medicare pts and we should not have to be put in this situation. How can we provide quality patient care an
tions on the provider's ability to provide medical care in the same manner as patients currently expect; the waits will be longer; the ability t
em for Medicare patients. Healthcare cannot stop and start for these patients with constant "fixes". The patients deserve better, and the ph
access to care. If you think it is difficult to make a practice work now, I cannot imagine what will happen if/when this cut goes into place.
atives in both the House and the Senate. Is anybody listening?
statement that our medicare recipients are valued less. The substantial fee reduction sends the message that their lives appear to be a com
g for years. We are not making a profit on our Medicare patients and any cut will be disastrous for patients and practices. Have you gone y
me to look at the overall picture and come up with a fair solution.
f a hospital system. Our participation status could change immediately if the orders come from above and I would be very, very happy to p
gislators and asked them to repeal this - reducing the fee schedule is not the way to attack the cost problem - changing the payment structu
ior to the cut barely met our cost, we know that this new reimbursement fall below our cost to provide the service. We will not (can not) co
community hospitals, we have no choice but to still care for the Medicare patients, but we may have to reduce work force, therefore reduc
Medicare fee schedule. Might be helpful to include that as a response option.
tied to Medicare Fee Schedule if the reduction is allowed.
service only practice.
n that is mission driven to treat the poor and vulnerable, we will continue to see the patients that need us. However, we will need to do so w
participating and in-network physicians causing a decline in patient care overall.
l resulting in significant cost increases to Medicare for our office based tests (we are cardiology practice)
sanity and take care of the SGR problem. Playing partisan politics with Medicare and Tricare will result in definite changes to the Congression
We can not operate at these rates.
dict the public will feel it in terms of longer waits for appointments, as more independent clinics will close or become absorbed by hospital sy
s to increase not decrease. Yet the reimbursement for care decreases. Where is the sense in this decision? Should we chose to limit the c
x medical problems, require more time and greater frequency of visits than any other patient and provide us the least amount of reimbursem
y more money. The public is misinformed as what are actual Doctor salaries. It is hard to make an average living now!!!
and consider equalizing the HOPPS system to Part B. It would help make up a significant portion of the expense and level the playing field.
nkrupt many practices with the determination. This certainley is not helping our economy. It will just put more people out of work. Family
force many practices to either limit their Medicare patient base or become non-par. This will mean less providers to care for these patients
ung healthy patients because reimbursements will not cover the time of seeing patients with multiple problems.
alty group and in a semi-retired community. With our departure from CMS it is going to greatly impact this community. We are in an area th
many surgeons currently considering retirement within the next 5 years will move up the date of retirement. I also think that this will furth
we are hospitalist however if we were in private practice we would have to make adjustments for the loss of revenue by either limiying Med
t primary care providers with a large Medicare Population. The 28.4 RVU will not cover practice cost for services provided.
not drop you as a payer! We are running a business and there is no need to see patients that will cost the business money.
y others will be rethinking how we will provide for the MC community. Most likely we will not see new MC patients & this will make it difficul
site, with the only full time on site oncologist for 200 miles. 50% of our patients are Medicare. We are currently loosing money on 90% of th
e nurse and hope a correct diagnosis is made along with the right treatment. No one in their right mind would spend the time, money, swe
take a break without fixing the SGR, doctors are going to take a break and not see any Medicare patients for two weeks.
patients than any other demographic, how are we to cut our costs 21%? What are YOU planning on doing to incentivise physicians to part
ace we have any flex without massive lay-offs which in reality hurt the patient process and will not make up the difference in the loss.
mediately, in order for physicians to keep their doors open. Physicians are making less then they did 25 years ago & expenses keep increas
nd not Medicare Fee Schedule.
hat sees 15,000 patients a year will close within the next 4 months.
hance they have is to allow balance billing.
this cut. Correct this insane problem.
on strike" or something. May lay off employees and scale back. Don't think a sustained 21% cut will be sustainable and still expect to make
ge diservice to our elderly patients. Alaska is in crisis right now with family practice Dr's not being able to keep there doors open and contin
some of the older physicians to retire sooner and patient's will be the one that will suffer..............
CADES OLD PROBLEM THAT HAS DEMONSTRATED OVER AND OVER AGAIN THAT OUR FEDERAL GOVERNMENT DOES NOT WANT TO REAL
this 7 doctor FP practice is looking at becoming non-participating Medicare providers. Enough is enough. Allowable fees remain flat. RACs
and our payers cannot be printed.
would be better contained by removing government from healthcare and requiring health insurance to be limited to catastrophic coverage o
ract based on a percentage of Medicare!!!!!
to lay off some employees because we will not be able to see medicare pts and that means no revenue coming in to pay employees.
atients in Eastern Oklahoma to have a private ENT care for their medical needs. I feel badly for these patients!
will be aggressively be cutting our expenses (mostly through staffing and benefits cost) and further evaluating current levels of services prov
gram, you are making it much more difficult for this underserved population to find care; those of us who do care for this population of pat
r direct costs of implementation. Not to mention trailing costs. Practice expenses are rising in the face of a 21% cut in practice revenue.
tice that loves our older patients and are sick of how our government treats them and us their providers.
ders survive?
members if the cut is not reversed.
ave to try so hard to get paid fo what you do. You have some very Good Physician out there who have worked very hard to provide quality
or reduce the level of care they provide. There are not enough physicians now.
y as it is. I can not accept any cuts in reimbursement
y , on a mandated fee schedule, that keeps decreasing each year, yet our costs...our insurance, our supplies, our rent, our utilities, our payr
MCR patients in finding physicians willing to see them. I have talked to physicians of all ages strongly considering getting out of medicine if
any physicians who have large Medicare patient populations
permanent changes to CMS payment policies (remove SRG to start).
alth care if something is not done to block this CMS reduction.
ntinue to see Medicare patients with this change
eous. How do you expect doctors to provide quality medical care when you cut reimbursement? Perhaps we should reduce the quality care g
for your medicare patients, cutting reimbusement is a major step in the wrong direction. With overhead costs surgeons barely break even o
likely they will likely find providers that do not accept Medicare patients in the near future.
you are basically going to gaurantee our Medicare population inadequate access to healthcare. As it is now, physicians consistently lose mo
kely make physicians either quit practicing or very abruptly discontinue treating new Medicare patients giving seniors no place to go for trea
the individuals that ultimately deliver healthcare have not been consider. It is also unfortunate that the services physicians provide continue
ady too low.This reduction will have a definate negative effect in Health Care!!
HER PAYERS ALSO USE THE MEDICARE FEE SCHEDULE AS A BASIS FOR THEIR FEE SCHEDULE, I WOULD HAVE TO CLOSE MY DOORS
viders except physicians have gotten annual cost of living or other increases for the past 8 years. I am compensated about the same as I w
questions) and these reimbursement changes are one of the many reasons why we have chosen our business model.
is reduction would cost us.
e Advantage is about to be gutted.
physician groups will lose their jobs due to consolidation of services. It is going to be a complete change to the entire industry as physician
ncreasing) regulations with the SGR reimbursement model.
and payments continue to fall? This is an improbable and impossible economic model.
hysician, financial hardship for our elderly population, doctor/nursing shortages, etc.
owever, a cut such as this when cash flow is already tight would certainly cause us to lay off staff and reduce the physicians compensation.
will be forced to sell our practice to hospital or shut down our doors if these cuts sustain.
riately with inflation over time.
sign any agreement tied to current year Medicare. Now most claim there is no choice although I have two major payors locked to 2006 and
rdize the long term viability of our organization.
visits, let alone catastrophic episodes.......and what about access to care?
care reduction many medical practices will not be able to provide care to the patient population it now serves and continue to exist. They w
om Medicaid, and now this. We barely make payroll as it is. The state is broke, does not pay and now this. How much more can you expe
sue payment outside of these structures. We will be laying off employees until there is literally no practice left.
ng it impossible for us to manage our practices with any type of long term strategic plans. Also, go after the fraud and abuse that is out the
of times. We are a volume-driven business and are impacted greatly by any change in the conversion factor. This hampers are ability to te
nd run lean due to other cuts in reimbursement and this is the straw that will break the camels back
g care at hospitals.
law plans vs State DOI Insurance rules) We already have huge admin overhead items where we do NOT get reimbursed...precerts, FREE in
f reimbursement is cut by 21.5%.
e can, remains relatively constant and yet you expect us to continue to provide quality care with the proposed fee reduction? How do you p
and medical school enrollment down who is going to care for these people?
s, not the cheapest.
ve none that are associated with current year. To your question, we are being asked to do more with less money. As a whole we do our be
TO MEDICAL CARE AND OR GOING TO REDUCE QUALITY FOR MEDICARE PATIENTS. YOU LADIES AND GENTLEMENT JUST DON'T GET IT
hospital over utilization and a class of "sicker" people that will now require longer times spent in overpriced systems. Congrats.
y fraudulent activities as opposed to taking the draconian approach of lowering payments to all
e a marginal profit at this time and would have no choice but to limit medical services provided at this clinic.
the number of providers leaving medicine/primary care; driving new graduates into specialty care
usiness Office staff by 2 people just to cope right now. If trend continues, we will lay off personnel, which means the patient isn't getting t
matter that more Americans have insurance if there are no physicians in practice to treat them.
ment has put me in a postition that I must not treat patients desiring to use me.
g in business should this cut take place. We also invision our primary doctors in the community limiting the number of Medicare patients, w
of the people who require care. Basing reimbursement on Medicare, which represents a small portion of our patients, is not an effective so
CP and hospitals will then need to bear the costs of providing services to these paitents who typically require ongoing care coordination and
n not do it with these cuts.
tape getting paid as it is. This huge cut will make it next to impossible to survive for a lot of practices.
probably stop seeing new Medicare patients. We can barley cover our cost at this point a 21.3% reduction could mean lay offs and for othe
ovide quality patient care and meet all the standards that CMS requires on such little money? The SGR is an old system and needs to be cha
s will be longer; the ability to see the medical doctor will be less; and the impact on patient's expectaions for surgery will be significantly del
deserve better, and the physicians deserve to at least be covered for their cost of providing care to our seniors. To Payors, there should b
en this cut goes into place. Many people will lose theirs jobs; we will see quality of care go down because of it and physicians will simply w
eir lives appear to be a commodity with declining value.
practices. Have you gone years without a payraise? Medicare/CMS makes us actually happy with 0-1% which is disappointing. How long d
uld be very, very happy to pull the plug on all federal programs.
hanging the payment structure overall to reward quality and efficiency is
ce. We will not (can not) continue to see patients if the cost of doing the service is greater than the reimbursement. We run a very efficien
work force, therefore reducing services. No one wins with these cuts!
ever, we will need to do so with fewer staff and will need to cut back in any area possible in order to continue our mission.
changes to the Congressional leadership done at the ballot box in November.
ome absorbed by hospital systems and the gifted will less likely want to pursue medicine as a career since pay will be less--which further com
ould we chose to limit the care we provide to patients offset our costs? No that would be unethical, but this decision does bring on the tem
least amount of reimbursement. What other industry could handle the government placing a 21.3% cut on their main customer? All other
e and level the playing field.
people out of work. Family Practices just can't take this kind of hit. Their Providers are not highly compensated like the speciality clinics.
s to care for these patients so they will end up in the E.R. (like Medi-Cal patients now) to receive care since they can't find a provider. The a
munity. We are in an area that is underserved in certain specialties and in fact, house only one doc in a certain specialty and with his depart
also think that this will further discourage students from going into surgery and will result in a shift work ethic which will further stress the c
venue by either limiying Medicare patients seen or laying off staff.
ts & this will make it difficult for MC patients to find care to take care of their medical needs for Neurology & many other specialities in this
loosing money on 90% of those who are on treatment. Even without the 21% cut we are considering cutting back as it may not be viable n
spend the time, money, sweat, etc to be a doctor to be CRAPPED on. Expecially by the meds
ncentivise physicians to participate?
difference in the loss.
go & expenses keep increasing. Sole physicians are on their own for a reason & usualy do not work well in a group practice. If this is not r
able and still expect to make a reasonable profit.
there doors open and continue to take Medicare patients.
T DOES NOT WANT TO REALLY FIX A PROBLEM JUST PUSH IS OFF OVER AND OVER AGAIN.....FIX IT NOW AND FIX IT RIGHT ! (how's tha
able fees remain flat. RACs and DACs abound. Time to get off the Medicare merry go-round.
d to catastrophic coverage only. Too many healthcare dollars are spent on people who have make work jobs and provide no actual healthca
n to pay employees.
urrent levels of services provided to all of our patient population.
re for this population of patients will be forced to limit the number of slots available in order to keep our doors open.
% cut in practice revenue.
very hard to provide quality care, and after 10 years of working are still paying off student loans. Because it takes so much time & money to
r rent, our utilities, our payrolls keep going up. You are succeeding in choking medicine...which means you will kill it. Do you care?
ng getting out of medicine if this actually occurs.
uld reduce the quality care given to each patient by 21%?
urgeons barely break even on medicare as it is currently.
ysicians consistently lose money when seeing Medicare patients. Further reducing Medicare payments will ensure that physicians will not be
niors no place to go for treatment.
physicians provide continue to be devalued by politicians and insurance companies. I hope that they know some qualified doctors to take c
E TO CLOSE MY DOORS
sated about the same as I was in the 1980s.
entire industry as physicians will no longer be valued by society.
e physicians compensation. Further contributing to unemployment and a struggling economy.
r payors locked to 2006 and 2007 Medicare which doesn't change without mutual agreement and one is looking at a fixed pricing arrangeme
nd continue to exist. They will discontinue participation and patients will have to find care elsewhere...the question will be where and how.
w much more can you expect to put on physicians, spend money on electronic medical records, spend money to get paid from payers who
ud and abuse that is out there not chip and stop punishing the physicians who are up in the middle of the night taking care of sick patients.
his hampers are ability to teach the future physicians of America, thus affecting the quantity and quality of physicians produced and exacerb
mbursed...precerts, FREE individual insurance consults (almost every practice has to function as their patients' health benefits advisor & exp
ee reduction? How do you propose that is to be accomplished?
y. As a whole we do our best to "follow the rules" but are in constant fear (being a large group) that Medicare is not only going to reduce re
LEMENT JUST DON'T GET IT. THIS IS GOING TO DEVISTATE PHYSICIAN PRACTICES. A 21% CUT IN MEDICARE DOES NOT STOP WITH M
ms. Congrats.
ns the patient isn't getting the service they deserve.
ber of Medicare patients, which will cause great delays in patients being seen, etc. The reduction will be devastating to patients and private
atients, is not an effective solution because others will join us and not take medicare at all.
going care coordination and management.
mean lay offs and for other practices closing their doors .
system and needs to be changed.
gery will be significantly delayed.
. To Payors, there should be a law that disallows for profit entities from taking the same discounts as a federal payor. There is no correlatio
and physicians will simply walk away from their practices.
s disappointing. How long do you think our physicians can carry Medicare without proper infusion of funding?
ment. We run a very efficient and lean practice and there is no more room to cut without compromising service and quality...which we refus
ill be less--which further compounds the access and shortage of physicians issues.
ision does bring on the temptation to do so. Will we see a decrease in the quality of care for patients in this country? If so, will those that
r main customer? All other industries are able to raise their prices if their costs rise and we can't we are tied to fee schedules!!!
like the speciality clinics.
y can't find a provider. The acutal expenses to the Medicare program will be higher as a result.
pecialty and with his departure the community would suffer greatly. Please, please reconsider other solutions. This is a solution just not a go
hich will further stress the current work force.
ny other specialities in this area.
ck as it may not be viable nor sustainable to treat at the current rate. My Physician has only had one paycheck in 4 months. He is committe
oup practice. If this is not resolved we will have a shortage of physicians, patients would not be able to receive care they deserve & which
FIX IT RIGHT ! (how's that?)
d provide no actual healthcare!
s so much time & money to run a practice, but we have to discount everything we do
ill it. Do you care?
e that physicians will not be able to see these patients.
me qualified doctors to take care of all the patients when all of us can no longer afford to treat them. To all of the commercial payors, I am
at a fixed pricing arrangement.
on will be where and how. Additionally, there will be a reduction of physicians in primary care to serve a growing population.
get paid from payers who laugh at the regs, put up with delays from payers, who concoct every reason not to pay, to delay and delay. Th
taking care of sick patients.
cians produced and exacerbating the looming physician shortage that is facing this country in the near future.
ealth benefits advisor & explain to patients the patient's coverages and benefits, explain why their insurance did not pay, define for patients
s not only going to reduce reimbursement to the point of us loosing money on every patient but also having a RAC auditor come in and take
RE DOES NOT STOP WITH MEDICARE. THIS WILL EFFECT ALMOST EVERY SINGLE PAYOR CONTRACT. FIX THE FORMULA - NOW! FOR T
ating to patients and private practice in our area.
payor. There is no correlation between a for profit payor financial model and the government's balanced budget requirements, so fees shoul
and quality...which we refuse to do.
untry? If so, will those that chose to give substandard care be penalized or will everyone receive a penalization even though the standard o
fee schedules!!!
his is a solution just not a good one.
n 4 months. He is committed and makes the payroll. Just not his.
care they deserve & which eveyone one has worked hard with preventitive care. Now people live longer, but I believe if the cut's go in effe
e commercial payors, I am sickened to see to profits your industry is making while at the same time you continue to raise premiums to your
ng population.
pay, to delay and delay. The one payer that was any good at all was Medicare, now this.
not pay, define for patients how their HSA work /HRS...and since we see individual pts who have different plans this workload never reduce
AC auditor come in and take back thousands of dollars in what they consider overpayments. Then we have the new HIPAA regulations, Red
E FORMULA - NOW! FOR THE SAKE OF ALL MEDICARE PATIENTS AND ALL PHYSICIAN PRACTICES.
requirements, so fees should not go down for private payors when Medicare fees reduce.
even though the standard of care did not change in their practice? If this is the future of medicine, who will chose to become physicians for
believe if the cut's go in effect we do no longer care & pepole will die.
e to raise premiums to your loyal customers during a financial and healthcare crisis. It is almost criminal, but when they have a monopoly
this workload never reduces we just move from one pt to the next. ALL practices are overly exposed to govt laws costing huge indirect cos
ew HIPAA regulations, Red Flags rule, Medicaid audits. Where does it end and why does anyone want to go into medicine today? Our syste
se to become physicians for our future generations? Will our physicians of today continue to practice medicine?
hen they have a monopoly it is difficult to curb these practices.
ws costing huge indirect costs...HIPAA, Fraud and Abuse, Fair Credit, OSHA, Risk Mgmt, malpractice risks and huge premiums...COME ON FE
o medicine today? Our system is too complex thanks to the government! Congress has no idea what we deal with on a daily basis yet they a
uge premiums...COME ON FEDS...Give us a break!!
h on a daily basis yet they are creating an untenable situation for us as well as our patients. I'm ranting and yes, I'm mad!
, I'm mad!
Medicare SGR Reduction
In what state is your practice located?
Response Response
Answer Options
Percent Count
State: 100.0% 520
answered question 520
skipped question 4
Number Response Date State:
1 Apr 1, 2010 1:55 AM NJ
2 Apr 1, 2010 1:58 AM VA
3 Apr 1, 2010 2:00 AM CA
4 Apr 1, 2010 2:01 AM FL
5 Apr 1, 2010 2:04 AM ME
6 Apr 1, 2010 2:06 AM NC
7 Apr 1, 2010 2:11 AM AZ
8 Apr 1, 2010 2:12 AM MT
9 Apr 1, 2010 2:12 AM VA
10 Apr 1, 2010 2:16 AM FL
11 Apr 1, 2010 2:17 AM FL
12 Apr 1, 2010 2:22 AM VA
13 Apr 1, 2010 2:24 AM AR
14 Apr 1, 2010 2:25 AM SC
15 Apr 1, 2010 2:26 AM CO
16 Apr 1, 2010 2:26 AM WA
17 Apr 1, 2010 2:28 AM VA
18 Apr 1, 2010 2:32 AM OH
19 Apr 1, 2010 2:40 AM OR
20 Apr 1, 2010 2:42 AM NY
21 Apr 1, 2010 2:44 AM OH
22 Apr 1, 2010 2:45 AM TX
23 Apr 1, 2010 2:45 AM NM
24 Apr 1, 2010 2:59 AM OR
25 Apr 1, 2010 3:13 AM CO
26 Apr 1, 2010 3:15 AM CA
27 Apr 1, 2010 3:22 AM WA
28 Apr 1, 2010 3:22 AM OR
29 Apr 1, 2010 3:50 AM IL
30 Apr 1, 2010 4:00 AM CA
31 Apr 1, 2010 4:00 AM WI
32 Apr 1, 2010 4:03 AM NJ
33 Apr 1, 2010 4:07 AM MD
34 Apr 1, 2010 4:38 AM CO
35 Apr 1, 2010 4:42 AM CO
36 Apr 1, 2010 5:12 AM CA
37 Apr 1, 2010 6:19 AM FL
38 Apr 1, 2010 7:04 AM NC
39 Apr 1, 2010 9:21 AM NC
40 Apr 1, 2010 9:53 AM LA
41 Apr 1, 2010 10:18 AM FL
42 Apr 1, 2010 10:40 AM NJ
43 Apr 1, 2010 10:46 AM GA
44 Apr 1, 2010 10:55 AM IN
45 Apr 1, 2010 11:06 AM FL
46 Apr 1, 2010 11:11 AM FL
47 Apr 1, 2010 11:35 AM FL
48 Apr 1, 2010 11:55 AM FL
49 Apr 1, 2010 11:58 AM ME
50 Apr 1, 2010 11:58 AM SC
51 Apr 1, 2010 11:58 AM PA
52 Apr 1, 2010 12:00 PM MA
53 Apr 1, 2010 12:00 PM TX
54 Apr 1, 2010 12:03 PM GA
55 Apr 1, 2010 12:04 PM FL
56 Apr 1, 2010 12:04 PM GA
57 Apr 1, 2010 12:06 PM MO
58 Apr 1, 2010 12:07 PM FL
59 Apr 1, 2010 12:07 PM KY
60 Apr 1, 2010 12:07 PM OH
61 Apr 1, 2010 12:11 PM FL
62 Apr 1, 2010 12:11 PM FL
63 Apr 1, 2010 12:12 PM MI
64 Apr 1, 2010 12:12 PM MI
65 Apr 1, 2010 12:12 PM FL
66 Apr 1, 2010 12:13 PM WV
67 Apr 1, 2010 12:14 PM NC
68 Apr 1, 2010 12:14 PM WA
69 Apr 1, 2010 12:15 PM KY
70 Apr 1, 2010 12:16 PM TX
71 Apr 1, 2010 12:16 PM NC
72 Apr 1, 2010 12:17 PM PA
73 Apr 1, 2010 12:19 PM AZ
74 Apr 1, 2010 12:20 PM OH
75 Apr 1, 2010 12:20 PM MD
76 Apr 1, 2010 12:21 PM OH
77 Apr 1, 2010 12:23 PM OH
78 Apr 1, 2010 12:23 PM NC
79 Apr 1, 2010 12:23 PM FL
80 Apr 1, 2010 12:24 PM VA
81 Apr 1, 2010 12:24 PM NY
82 Apr 1, 2010 12:25 PM NY
83 Apr 1, 2010 12:25 PM NY
84 Apr 1, 2010 12:26 PM NC
85 Apr 1, 2010 12:27 PM FL
86 Apr 1, 2010 12:27 PM IL
87 Apr 1, 2010 12:29 PM SC
88 Apr 1, 2010 12:30 PM OH
89 Apr 1, 2010 12:31 PM MI
90 Apr 1, 2010 12:32 PM MI
91 Apr 1, 2010 12:33 PM NJ
92 Apr 1, 2010 12:33 PM GA
93 Apr 1, 2010 12:33 PM TN
94 Apr 1, 2010 12:34 PM NC
95 Apr 1, 2010 12:35 PM WI
96 Apr 1, 2010 12:37 PM NY
97 Apr 1, 2010 12:37 PM NJ
98 Apr 1, 2010 12:37 PM MI
99 Apr 1, 2010 12:39 PM FL
100 Apr 1, 2010 12:42 PM NC
101 Apr 1, 2010 12:43 PM NY
102 Apr 1, 2010 12:43 PM FL
103 Apr 1, 2010 12:44 PM OR
104 Apr 1, 2010 12:45 PM RI
105 Apr 1, 2010 12:45 PM MI
106 Apr 1, 2010 12:45 PM TX
107 Apr 1, 2010 12:46 PM SC
108 Apr 1, 2010 12:47 PM TN
109 Apr 1, 2010 12:48 PM NY
110 Apr 1, 2010 12:49 PM FL
111 Apr 1, 2010 12:49 PM KY
112 Apr 1, 2010 12:50 PM NY
113 Apr 1, 2010 12:50 PM PA
114 Apr 1, 2010 12:51 PM FL
115 Apr 1, 2010 12:51 PM FL
116 Apr 1, 2010 12:52 PM TX
117 Apr 1, 2010 12:53 PM NC
118 Apr 1, 2010 12:54 PM SC
119 Apr 1, 2010 12:55 PM TX
120 Apr 1, 2010 12:56 PM AR
121 Apr 1, 2010 12:57 PM TN
122 Apr 1, 2010 12:58 PM NJ
123 Apr 1, 2010 12:58 PM GA
124 Apr 1, 2010 12:58 PM IL
125 Apr 1, 2010 12:59 PM OH
126 Apr 1, 2010 1:01 PM SC
127 Apr 1, 2010 1:03 PM SC
128 Apr 1, 2010 1:03 PM SC
129 Apr 1, 2010 1:04 PM MO
130 Apr 1, 2010 1:04 PM NC
131 Apr 1, 2010 1:05 PM IN
132 Apr 1, 2010 1:05 PM ND
133 Apr 1, 2010 1:07 PM NY
134 Apr 1, 2010 1:08 PM MO
135 Apr 1, 2010 1:09 PM CA
136 Apr 1, 2010 1:10 PM GA
137 Apr 1, 2010 1:11 PM IL
138 Apr 1, 2010 1:11 PM FL
139 Apr 1, 2010 1:11 PM FL
140 Apr 1, 2010 1:11 PM FL
141 Apr 1, 2010 1:12 PM GA
142 Apr 1, 2010 1:12 PM VA
143 Apr 1, 2010 1:14 PM NY
144 Apr 1, 2010 1:15 PM LA
145 Apr 1, 2010 1:18 PM KS
146 Apr 1, 2010 1:19 PM FL
147 Apr 1, 2010 1:19 PM TX
148 Apr 1, 2010 1:21 PM OK
149 Apr 1, 2010 1:21 PM VA
150 Apr 1, 2010 1:21 PM MO
151 Apr 1, 2010 1:22 PM FL
152 Apr 1, 2010 1:22 PM ME
153 Apr 1, 2010 1:23 PM NY
154 Apr 1, 2010 1:23 PM IA
155 Apr 1, 2010 1:23 PM VA
156 Apr 1, 2010 1:24 PM NY
157 Apr 1, 2010 1:24 PM MT
158 Apr 1, 2010 1:27 PM NY
159 Apr 1, 2010 1:28 PM NC
160 Apr 1, 2010 1:28 PM PA
161 Apr 1, 2010 1:28 PM IN
162 Apr 1, 2010 1:29 PM CT
163 Apr 1, 2010 1:30 PM TX
164 Apr 1, 2010 1:31 PM TX
165 Apr 1, 2010 1:31 PM NE
166 Apr 1, 2010 1:33 PM GA
167 Apr 1, 2010 1:33 PM TN
168 Apr 1, 2010 1:34 PM NJ
169 Apr 1, 2010 1:34 PM OH
170 Apr 1, 2010 1:36 PM TN
171 Apr 1, 2010 1:36 PM OR
172 Apr 1, 2010 1:39 PM KY
173 Apr 1, 2010 1:39 PM FL
174 Apr 1, 2010 1:39 PM SC
175 Apr 1, 2010 1:40 PM IN
176 Apr 1, 2010 1:41 PM IL
177 Apr 1, 2010 1:43 PM RI
178 Apr 1, 2010 1:43 PM TN
179 Apr 1, 2010 1:44 PM IA
180 Apr 1, 2010 1:45 PM WI
181 Apr 1, 2010 1:46 PM OR
182 Apr 1, 2010 1:46 PM FL
183 Apr 1, 2010 1:47 PM IL
184 Apr 1, 2010 1:48 PM TN
185 Apr 1, 2010 1:48 PM NY
186 Apr 1, 2010 1:48 PM SC
187 Apr 1, 2010 1:49 PM TX
188 Apr 1, 2010 1:49 PM OR
189 Apr 1, 2010 1:51 PM KS
190 Apr 1, 2010 1:51 PM FL
191 Apr 1, 2010 1:51 PM MS
192 Apr 1, 2010 1:51 PM IN
193 Apr 1, 2010 1:51 PM MT
194 Apr 1, 2010 1:53 PM SC
195 Apr 1, 2010 1:54 PM TX
196 Apr 1, 2010 1:54 PM NJ
197 Apr 1, 2010 1:56 PM OK
198 Apr 1, 2010 1:58 PM OR
199 Apr 1, 2010 1:58 PM TX
200 Apr 1, 2010 1:59 PM TN
201 Apr 1, 2010 1:59 PM TN
202 Apr 1, 2010 1:59 PM FL
203 Apr 1, 2010 2:01 PM CO
204 Apr 1, 2010 2:03 PM OH
205 Apr 1, 2010 2:04 PM NJ
206 Apr 1, 2010 2:04 PM KS
207 Apr 1, 2010 2:04 PM MT
208 Apr 1, 2010 2:04 PM OR
209 Apr 1, 2010 2:04 PM OH
210 Apr 1, 2010 2:05 PM GA
211 Apr 1, 2010 2:06 PM IN
212 Apr 1, 2010 2:06 PM PA
213 Apr 1, 2010 2:06 PM NC
214 Apr 1, 2010 2:07 PM OR
215 Apr 1, 2010 2:07 PM FL
216 Apr 1, 2010 2:08 PM OR
217 Apr 1, 2010 2:08 PM LA
218 Apr 1, 2010 2:12 PM TX
219 Apr 1, 2010 2:13 PM AR
220 Apr 1, 2010 2:14 PM TX
221 Apr 1, 2010 2:14 PM OR
222 Apr 1, 2010 2:17 PM WA
223 Apr 1, 2010 2:18 PM TX
224 Apr 1, 2010 2:19 PM NY
225 Apr 1, 2010 2:22 PM MS
226 Apr 1, 2010 2:25 PM FL
227 Apr 1, 2010 2:25 PM SC
228 Apr 1, 2010 2:27 PM WA
229 Apr 1, 2010 2:28 PM IL
230 Apr 1, 2010 2:31 PM NE
231 Apr 1, 2010 2:31 PM IL
232 Apr 1, 2010 2:32 PM CT
233 Apr 1, 2010 2:35 PM FL
234 Apr 1, 2010 2:35 PM FL
235 Apr 1, 2010 2:35 PM OH
236 Apr 1, 2010 2:37 PM CO
237 Apr 1, 2010 2:40 PM FL
238 Apr 1, 2010 2:41 PM ID
239 Apr 1, 2010 2:41 PM GA
240 Apr 1, 2010 2:42 PM TX
241 Apr 1, 2010 2:43 PM TX
242 Apr 1, 2010 2:43 PM GA
243 Apr 1, 2010 2:44 PM FL
244 Apr 1, 2010 2:46 PM GA
245 Apr 1, 2010 2:46 PM NY
246 Apr 1, 2010 2:47 PM GA
247 Apr 1, 2010 2:48 PM GA
248 Apr 1, 2010 2:48 PM MS
249 Apr 1, 2010 2:50 PM GA
250 Apr 1, 2010 2:52 PM GA
251 Apr 1, 2010 2:53 PM AZ
252 Apr 1, 2010 2:53 PM GA
253 Apr 1, 2010 2:54 PM KS
254 Apr 1, 2010 2:54 PM GA
255 Apr 1, 2010 2:54 PM IL
256 Apr 1, 2010 2:55 PM GA
257 Apr 1, 2010 2:56 PM GA
258 Apr 1, 2010 2:57 PM KS
259 Apr 1, 2010 2:58 PM WY
260 Apr 1, 2010 3:00 PM VA
261 Apr 1, 2010 3:00 PM GA
262 Apr 1, 2010 3:00 PM PA
263 Apr 1, 2010 3:01 PM GA
264 Apr 1, 2010 3:02 PM CO
265 Apr 1, 2010 3:02 PM IL
266 Apr 1, 2010 3:06 PM TX
267 Apr 1, 2010 3:06 PM MA
268 Apr 1, 2010 3:07 PM MI
269 Apr 1, 2010 3:07 PM PA
270 Apr 1, 2010 3:08 PM GA
271 Apr 1, 2010 3:08 PM TN
272 Apr 1, 2010 3:09 PM CA
273 Apr 1, 2010 3:10 PM MS
274 Apr 1, 2010 3:13 PM MS
275 Apr 1, 2010 3:13 PM RI
276 Apr 1, 2010 3:15 PM AZ
277 Apr 1, 2010 3:15 PM FL
278 Apr 1, 2010 3:16 PM GA
279 Apr 1, 2010 3:17 PM CA
280 Apr 1, 2010 3:17 PM KS
281 Apr 1, 2010 3:17 PM WA
282 Apr 1, 2010 3:19 PM OK
283 Apr 1, 2010 3:19 PM OR
284 Apr 1, 2010 3:20 PM CA
285 Apr 1, 2010 3:20 PM OR
286 Apr 1, 2010 3:21 PM PA
287 Apr 1, 2010 3:22 PM WY
288 Apr 1, 2010 3:22 PM IL
289 Apr 1, 2010 3:23 PM GA
290 Apr 1, 2010 3:23 PM IN
291 Apr 1, 2010 3:24 PM GA
292 Apr 1, 2010 3:24 PM OR
293 Apr 1, 2010 3:24 PM FL
294 Apr 1, 2010 3:24 PM WY
295 Apr 1, 2010 3:25 PM MN
296 Apr 1, 2010 3:32 PM KY
297 Apr 1, 2010 3:33 PM UT
298 Apr 1, 2010 3:34 PM MT
299 Apr 1, 2010 3:37 PM GA
300 Apr 1, 2010 3:37 PM CA
301 Apr 1, 2010 3:38 PM NC
302 Apr 1, 2010 3:39 PM NV
303 Apr 1, 2010 3:40 PM TX
304 Apr 1, 2010 3:40 PM CA
305 Apr 1, 2010 3:41 PM NV
306 Apr 1, 2010 3:42 PM GA
307 Apr 1, 2010 3:43 PM NJ
308 Apr 1, 2010 3:43 PM GA
309 Apr 1, 2010 3:46 PM CA
310 Apr 1, 2010 3:47 PM NM
311 Apr 1, 2010 3:48 PM TX
312 Apr 1, 2010 3:48 PM TX
313 Apr 1, 2010 3:48 PM GA
314 Apr 1, 2010 3:50 PM NC
315 Apr 1, 2010 3:51 PM NV
316 Apr 1, 2010 3:55 PM FL
317 Apr 1, 2010 3:56 PM ND
318 Apr 1, 2010 3:59 PM SC
319 Apr 1, 2010 3:59 PM CT
320 Apr 1, 2010 4:07 PM GA
321 Apr 1, 2010 4:09 PM PA
322 Apr 1, 2010 4:10 PM VA
323 Apr 1, 2010 4:11 PM MT
324 Apr 1, 2010 4:12 PM WA
325 Apr 1, 2010 4:13 PM CO
326 Apr 1, 2010 4:14 PM TX
327 Apr 1, 2010 4:15 PM TN
328 Apr 1, 2010 4:16 PM AZ
329 Apr 1, 2010 4:19 PM CA
330 Apr 1, 2010 4:21 PM NC
331 Apr 1, 2010 4:21 PM UT
332 Apr 1, 2010 4:22 PM AL
333 Apr 1, 2010 4:23 PM MS
334 Apr 1, 2010 4:24 PM WI
335 Apr 1, 2010 4:25 PM AK
336 Apr 1, 2010 4:26 PM WA
337 Apr 1, 2010 4:28 PM CA
338 Apr 1, 2010 4:28 PM KY
339 Apr 1, 2010 4:29 PM NM
340 Apr 1, 2010 4:32 PM AK
341 Apr 1, 2010 4:32 PM MA
342 Apr 1, 2010 4:32 PM OR
343 Apr 1, 2010 4:33 PM MI
344 Apr 1, 2010 4:34 PM WA
345 Apr 1, 2010 4:35 PM GA
346 Apr 1, 2010 4:36 PM OH
347 Apr 1, 2010 4:37 PM NV
348 Apr 1, 2010 4:38 PM GA
349 Apr 1, 2010 4:39 PM NC
350 Apr 1, 2010 4:41 PM OR
351 Apr 1, 2010 4:43 PM MN
352 Apr 1, 2010 4:44 PM OR
353 Apr 1, 2010 4:46 PM NC
354 Apr 1, 2010 4:47 PM AL
355 Apr 1, 2010 4:52 PM CA
356 Apr 1, 2010 4:54 PM CA
357 Apr 1, 2010 4:55 PM TN
358 Apr 1, 2010 5:01 PM FL
359 Apr 1, 2010 5:01 PM WY
360 Apr 1, 2010 5:04 PM NV
361 Apr 1, 2010 5:05 PM AZ
362 Apr 1, 2010 5:07 PM CO
363 Apr 1, 2010 5:07 PM WA
364 Apr 1, 2010 5:09 PM ME
365 Apr 1, 2010 5:13 PM KS
366 Apr 1, 2010 5:17 PM TX
367 Apr 1, 2010 5:19 PM NC
368 Apr 1, 2010 5:20 PM OR
369 Apr 1, 2010 5:20 PM CA
370 Apr 1, 2010 5:20 PM WA
371 Apr 1, 2010 5:21 PM CA
372 Apr 1, 2010 5:30 PM AZ
373 Apr 1, 2010 5:41 PM WA
374 Apr 1, 2010 5:51 PM AZ
375 Apr 1, 2010 5:51 PM WA
376 Apr 1, 2010 5:53 PM TX
377 Apr 1, 2010 5:57 PM NC
378 Apr 1, 2010 6:00 PM WA
379 Apr 1, 2010 6:06 PM NY
380 Apr 1, 2010 6:07 PM PA
381 Apr 1, 2010 6:12 PM GA
382 Apr 1, 2010 6:13 PM OH
383 Apr 1, 2010 6:16 PM WA
384 Apr 1, 2010 6:16 PM TX
385 Apr 1, 2010 6:21 PM GA
386 Apr 1, 2010 6:23 PM GA
387 Apr 1, 2010 6:23 PM NC
388 Apr 1, 2010 6:24 PM OH
389 Apr 1, 2010 6:25 PM AK
390 Apr 1, 2010 6:25 PM NC
391 Apr 1, 2010 6:27 PM TX
392 Apr 1, 2010 6:28 PM PA
393 Apr 1, 2010 6:30 PM GA
394 Apr 1, 2010 6:31 PM PA
395 Apr 1, 2010 6:32 PM TX
396 Apr 1, 2010 6:33 PM VA
397 Apr 1, 2010 6:33 PM CO
398 Apr 1, 2010 6:38 PM TX
399 Apr 1, 2010 6:41 PM OH
400 Apr 1, 2010 6:41 PM OH
401 Apr 1, 2010 6:43 PM GA
402 Apr 1, 2010 6:57 PM AZ
403 Apr 1, 2010 6:58 PM SC
404 Apr 1, 2010 6:59 PM IA
405 Apr 1, 2010 6:59 PM MS
406 Apr 1, 2010 7:06 PM OH
407 Apr 1, 2010 7:11 PM GA
408 Apr 1, 2010 7:13 PM GA
409 Apr 1, 2010 7:14 PM FL
410 Apr 1, 2010 7:15 PM GA
411 Apr 1, 2010 7:16 PM CA
412 Apr 1, 2010 7:17 PM OR
413 Apr 1, 2010 7:20 PM TX
414 Apr 1, 2010 7:20 PM MI
415 Apr 1, 2010 7:29 PM GA
416 Apr 1, 2010 7:33 PM GA
417 Apr 1, 2010 7:36 PM FL
418 Apr 1, 2010 7:39 PM CA
419 Apr 1, 2010 7:48 PM OK
420 Apr 1, 2010 7:57 PM GA
421 Apr 1, 2010 8:00 PM CO
422 Apr 1, 2010 8:03 PM GA
423 Apr 1, 2010 8:04 PM OR
424 Apr 1, 2010 8:07 PM WA
425 Apr 1, 2010 8:07 PM OR
426 Apr 1, 2010 8:08 PM GA
427 Apr 1, 2010 8:09 PM OR
428 Apr 1, 2010 8:09 PM OR
429 Apr 1, 2010 8:32 PM WY
430 Apr 1, 2010 8:47 PM TX
431 Apr 1, 2010 8:49 PM GA
432 Apr 1, 2010 8:50 PM CA
433 Apr 1, 2010 8:53 PM MN
434 Apr 1, 2010 9:12 PM NV
435 Apr 1, 2010 9:17 PM WA
436 Apr 1, 2010 9:26 PM GA
437 Apr 1, 2010 9:29 PM CO
438 Apr 1, 2010 9:41 PM GA
439 Apr 1, 2010 9:43 PM CA
440 Apr 1, 2010 9:48 PM AL
441 Apr 1, 2010 9:49 PM ID
442 Apr 1, 2010 9:53 PM SC
443 Apr 1, 2010 9:58 PM OR
444 Apr 1, 2010 10:05 PM NC
445 Apr 1, 2010 10:07 PM CO
446 Apr 1, 2010 10:09 PM NC
447 Apr 1, 2010 10:15 PM GA
448 Apr 1, 2010 10:23 PM CA
449 Apr 1, 2010 10:29 PM IN
450 Apr 1, 2010 10:41 PM IA
451 Apr 1, 2010 10:42 PM CA
452 Apr 1, 2010 10:46 PM TN
453 Apr 1, 2010 10:52 PM NV
454 Apr 1, 2010 10:53 PM OR
455 Apr 1, 2010 11:06 PM GA
456 Apr 1, 2010 11:41 PM SC
457 Apr 1, 2010 11:52 PM GA
458 Apr 2, 2010 12:16 AM GA
459 Apr 2, 2010 12:17 AM FL
460 Apr 2, 2010 12:21 AM TX
461 Apr 2, 2010 12:26 AM MT
462 Apr 2, 2010 12:58 AM PA
463 Apr 2, 2010 1:08 AM OR
464 Apr 2, 2010 1:40 AM OH
465 Apr 2, 2010 10:08 AM CT
466 Apr 2, 2010 11:15 AM VA
467 Apr 2, 2010 11:17 AM PA
468 Apr 2, 2010 11:24 AM MN
469 Apr 2, 2010 11:53 AM NC
470 Apr 2, 2010 12:16 PM IN
471 Apr 2, 2010 12:25 PM GA
472 Apr 2, 2010 12:37 PM IN
473 Apr 2, 2010 12:43 PM IN
474 Apr 2, 2010 12:44 PM FL
475 Apr 2, 2010 12:57 PM IL
476 Apr 2, 2010 1:06 PM NC
477 Apr 2, 2010 1:22 PM PA
478 Apr 2, 2010 1:41 PM SD
479 Apr 2, 2010 1:52 PM TX
480 Apr 2, 2010 2:02 PM OH
481 Apr 2, 2010 2:04 PM NY
482 Apr 2, 2010 2:06 PM WA
483 Apr 2, 2010 2:08 PM PA
484 Apr 2, 2010 2:12 PM NC
485 Apr 2, 2010 2:16 PM AR
486 Apr 2, 2010 2:18 PM GA
487 Apr 2, 2010 2:24 PM TX
488 Apr 2, 2010 2:34 PM TX
489 Apr 2, 2010 3:03 PM OR
490 Apr 2, 2010 3:16 PM VA
491 Apr 2, 2010 3:32 PM AR
492 Apr 2, 2010 3:57 PM WA
493 Apr 2, 2010 4:15 PM FL
494 Apr 2, 2010 4:18 PM GA
495 Apr 2, 2010 4:27 PM KY
496 Apr 2, 2010 4:33 PM OR
497 Apr 2, 2010 4:41 PM MO
498 Apr 2, 2010 5:09 PM OR
499 Apr 2, 2010 5:14 PM GA
500 Apr 2, 2010 5:25 PM IN
501 Apr 2, 2010 5:33 PM WA
502 Apr 2, 2010 5:36 PM OR
503 Apr 2, 2010 6:06 PM WA
504 Apr 2, 2010 6:13 PM IN
505 Apr 2, 2010 7:44 PM GA
506 Apr 2, 2010 8:02 PM OR
507 Apr 2, 2010 9:08 PM GA
508 Apr 2, 2010 9:53 PM VA
509 Apr 2, 2010 10:06 PM CA
510 Apr 3, 2010 1:03 AM OR
511 Apr 3, 2010 2:59 AM SC
512 Apr 3, 2010 3:48 AM GU
513 Apr 3, 2010 4:35 AM GA
514 Apr 3, 2010 11:42 AM IN
515 Apr 3, 2010 1:54 PM FL
516 Apr 3, 2010 3:22 PM IN
517 Apr 3, 2010 6:27 PM GA
518 Apr 3, 2010 6:28 PM OH
519 Apr 4, 2010 12:45 AM IN
520 Apr 4, 2010 4:13 AM GA
In what state is your practice located?
State:
