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A Voice for Private Physicians Since 1943

AAPS Congratulates Dr. Tom Price; Makes Two Requests

The Association of American Physicians and Surgeons (AAPS) congratulates Rep.  Tom Price, M.D., (R-Ga.) on winning confirmation as Secretary of Health and Human Services (HHS) over bitter opposition.

As reported in the Washington Post, one major objection to Dr. Price was his support for some “unorthodox” views also held by AAPS: freedom for patients and physicians, and the sanctity of the patient-physician relationship.

“HHS has denied or restricted freedom in medicine in countless ways,” states AAPS executive director Jane Orient, M.D. “One step Dr. Price could take immediately is to reverse the HHS policy that forces seniors to accept Medicare Part A or forgo all Social Security benefits.”

As Chris Jacobs explains: “The federal government holds individuals’ Social Security benefits hostage as leverage to forcibly enroll them in Medicare Part A.” Jacobs reports that a lawsuit by several seniors, including former House Majority Leader Dick Armey (Hall v. Sebelius) failed, but the Trump Administration could reverse this policy. Tax savings would likely be modest, but why should the government force tax expenditures for those who would prefer to provide for themselves, he asks.

“Another action that Price could take, in order to protect Medicare patients’ access to independent physicians, is to expand the exemptions in the Final Rule for MACRA, the new Medicare payment methodology,” states Dr. Orient. “HHS has acknowledged the tremendous cost of compliance and the likelihood that small practices will be penalized. The exemption allowed for ‘low volume’ is virtually meaningless—less than $30,000 in Part B charges or fewer than 101 Medicare patients.”

AAPS has recommended that the Final Rule be withdrawn in its entirety. “But at least HHS could abide by Congress’s expressed intention that MACRA be voluntary,” said Dr. Orient. “It could allow patients and physicians to decline MACRA and adopt payment based on patient value rather than by bureaucratically dictated value. It could allow Medicare non-participating (“non-par”) doctors to choose to be exempt.”

HHS has the authority to set policy that defines non-covered services. “It should declare that patients of non-par doctors may decline to file a claim and have the service considered as ‘non-covered,’ with the fee determined by mutual agreement,” she suggested.

“One thing patients might value is a truly confidential visit of adequate length to discuss all the patient’s concerns. The taxpayer would not be burdened for the visit, and it could save a lot in the long run.”

The Association of American Physicians and Surgeons (AAPS) represents physicians in virtually all specialties and every state. Founded in 1943, AAPS has the motto “omnia pro aegroto,” which means “all for the patient.”

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HHS Secretary Tom Price and the AAPS