No Rest for the Weary
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Colleagues:
With the big bill passed, one would think that there may be a pause for the health care system to absorb these changes. Unfortunately, the House of Medicine has no such luck.
In a recent NY Times article, the role of the AMA RUC committee is being questioned, and along with it, the same old zero-sum game where the Medicare Part B pie is not growing, while other parts of Medicare receive annual inflationary adjustments. A likely outcome is the appointment of a new reimbursement sheriff who once again pits specialist against primary care, hospital-based vs private practitioner. This potentially will occur without a practicing physician’s input, making it just another aspect of the practice of medicine dictated to us. The across the board 2.5% downward efficiency adjustment for all procedures is just one potential outcome if not opined by you and reversed prior to January 2026. The House of Medicine needs to unite to help grow the Medicare Part B pie to sustain the practice of medicine for all specialties. We need to avoid the temptation to be divided and conquered. I encourage all to read the article and share your thoughts with MSSNY leadership on how we can best make sure any proposed changes help more than hurt.
In other news, the Doctor’s caucus has endorsed two federal bills that seek to curtail the out-of-control prior authorization debacle. H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act, and H.R. 3514, the Seniors Timely Access to Care Act, seek to improve the PA process by requiring Board Certified specialists to be involved in any appeals, make sure there are written guidelines, and that ultimately the process results in improved patient experience.
On the local front, MSSNY leadership met with Senate Majority Leader Andrea Stewart Cousins at a recent fundraiser. It appears the $750 million hit due to OBBB is, on initial glance, enough to warrant a special session, but the $3 billion in cuts to Essential plans and Medicaid in general will bring out an active budget fight come 2026. We need to remain vigilant and continue to advocate for our fellow physicians and patient access. I would encourage all to give to mssnypac.org as we brace for the upcoming fight.
Finally, on a sad note, as of my writing, I was informed Dr. Milton A. Gumbs, former President and Treasurer of Bronx County, and former Dean Emeritus at Einstein College of Medicine, has passed away. I, having worked alongside him at Bronx County and while he was CMO when I was Chair of Otolaryngology at Bronx Lebanon, can testify to his talent as a surgeon, his charm as a person, and as a political survivor. His looming presence and smile will be missed.
All the best,
David Jakubowicz, MD, FACS
MSSNY President
