Medicare Law Sparks Protest Senior Groups Divided On New Law Guiding Out-Of-Pocket Payments To Docs

A conservative seniors group Tuesday asked a federal court to block a new law that the organization says unfairly restricts older Americans’ access to medical services outside Medicare.

United Seniors Association President Sandra Butler said its 600,000 members “are outraged by these newly enacted limitations on their medical and personal freedoms.”

Under the new legislation, physicians who allow patients to pay directly for services that would be covered by Medicare - and thus outside Medicare’s caps on doctors fees - must file notice of their charges with the federal government and forgo all participation in the Medicare program for two years.

United Seniors said older Americans should have the freedom to pay out of their own pockets for whatever health services they choose, from whichever doctor they choose.

But advocates of the new law passed last summer as part of the Balanced Budget Act of 1997 - including the American Association of Retired Persons - dispute that it limits seniors’ access to health care services.

The law, which takes effect Thursday, for the first time permits the so-called private contracting of services covered by Medicare. But it also includes greater consumer protections against unscrupulous medical practitioners.

The Health and Human Services Department, the defendant in the court case, said Tuesday that it could not comment on the pending suit.

But Nancy-Ann Min DeParle, administrator of the Health Care Financing Administration, said seniors always have been able to pay for medical care not covered by Medicare.

“Beneficiaries have always been able to pay out of their own pockets for services not covered by Medicare without penalty to themselves or their physicians. The new Balanced Budget Act does not change that,” she said.

Seniors who elect to pay directly for services outside Medicare are free to continue to participate in the program, but through other physicians.

Federal officials and members of Congress had sought to keep doctors from double-billing for services or overcharging vulnerable Medicare patients.

The American Medical Association, the nation’s largest physician group, applauded the new private contracting provisions. But like the United Seniors Association, the AMA opposes restrictions like the two-year ban on Medicare participation.

Sen. Jon Kyl, R-Ariz., and other lawmakers have introduced legislation in Congress to repeal the restrictions.

Former Texas Republican Rep. Beau Boulter, who is representing United Seniors in the lawsuit, said the group also would work to overturn the objectionable provisions on Capitol Hill.

Doctors, however, are divided.

The American College of Physicians, the largest group of medical specialists, said in November that it feared Kyl’s plan would “be seen by our patients as an effort to increase our incomes at patient expense.”

Seniors Peggy Sanborn of Apopka, Fla., and Toni Parsons of Bradenton, Fla., who have joined in the lawsuit filed in U.S. District Court for the District of Columbia, told a Washington news conference Tuesday that they feared their doctors would deny medical services not covered by Medicare.