Physician QAAP

Tom Bissonnette, MS, RN, MNA Associate Executive Director of Nursing Practice attended the recent Senate Appropriations Subcommittee on Community Health, held on October 20, 2009. You may have read about this in the newspaper – doctors and others in white coats flooded the Capitol and the Senate Hearing Room in the Boji Tower in downtown Lansing.

Here are his comments:

Tuesday October 20th was a great day to be at the state Capitol in Lansing!  MNA was in the thick of the activities, participating in the “physician tax” rally and committee hearing as well as attending the Advanced Practice Nurses’ lobby day.  More on the lobby day in a future blog.

Our state’s budget battles are well known, and this week the physicians were battling each other over the issue of “taxing” doctors in order to backfill the 8% Medicaid cuts in the Department of Community Health budget.  MNA has decided to support this new revenue, officially known as the Quality Assurance Assessment Program, or QAAP (pronounced QUAP), as a means of reducing the dramatic cuts.  We know too well the current inadequate funding of Medicaid, and the devastating cuts in the Medicaid budget that just went to the Governor for signature are going to completely rip apart the health care safety net for our most vulnerable patient population—the poor, people with disabilities, and children.  A majority of physicians currently do not accept Medicaid patients, and this number would only worsen with these cuts.

The QAAP for physicians would tax all doctors 3% on their revenues in order to leverage more federal dollars to fund Michigan’s Medicaid program.  Medicaid reimbursement would then be increased to Medicare reimbursement levels—a dramatic increase!  Financial experts predict physicians would need at least 4% of their gross revenues to be from Medicaid in order to “break even” under the QAAP. 

Generally, physicians who do not accept Medicaid patients (such as specialists), or who do not have the ability to increase their Medicaid caseload to sufficient revenue levels, are opposed to the QAAP.  Physicians who do (such as emergency medicine, primary care and pediatricians), support the QAAP.  Exceptions include those who do not trust government to return the additional federal monies only to the Medicaid program. 

 House Bill 5386, currently residing in the Senate Health Policy Committee without a scheduled hearing, needs amending to address some of the concerns expressed at the Senate Department of Community Health Appropriations Sub-committee hearing.  A robust discussion is favored, yet the patient will die if discussion is prolonged.

You can read more about the proposed physician QAAP on our web site page by clicking here.


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