AAPS Asks Court to Stall Restrictions on Medicare Patients’ Tests and Referrals
Mar 13, 2013
If allowed to go into effect, a March 1 notice from HHS (the Department of Health and Human Services) will eliminate Medicare payments for tests and referrals ordered by physicians not enrolled in the Medicare program, as of May 1.
"Because of Medicare's increasingly costly and restrictive rules placed on doctors, many Medicare-eligible patients are receiving medical care from physicians not enrolled in the program," states Jane M. Orient, M.D., executive director of the Association of American Physicians and Surgeons (AAPS). "This looming change by HHS will deprive the patients of benefits for blood tests, x-rays, and specialist consultations—benefits for which they were forced to pay all their working lives, and which would be covered if ordered or referred by a Medicare-enrolled physician."
AAPS filed an emergency motion for injunctive relief today in the U.S. Court of Appeals for the District of Columbia Circuit.
The benefit cut results from changes to Medicare's Provider Enrollment, Chain and Ownership System (PECOS). HHS has additional authority in this area of Medicare as a result of the Patient Protection and Affordable Care Act (PPACA or "ObamaCare"), and AAPS's challenge to PECOS is part of its lawsuit against PPACA. These changes do not apply to physicians with a Medicare status of "opted-out," "non-PAR," or "PAR."
AAPS filed suit against PPACA three days after it was signed into law, but the case was stayed pending a Supreme Court decision in the case brought by the National Federation of Independent Business (NFIB) and 26 states.
In upholding ObamaCare as outside Congress's power to regulate but within its power to tax, the Supreme Court acknowledged that "any tax must still comply with other requirements in the Constitution." The motion filed by AAPS is the first to ask an appellate court to rule on whether PPACA violated the Origination Clause of the U.S. Constitution, which requires that all "bills for raising revenue" originate in the House of Representatives.
The Founders fought for independence largely because of excessive taxation without representation. As a result, when they drafted the Constitution, they insisted that taxes originate in the House, the legislative body closest to the People, both in representation and in election cycles.
ObamaCare originated in Senator Reid's 2000-page amendment to a 6-page House bill about tax credits for members of the armed forces who are called into overseas assignments. AAPS has raised several arguments why ObamaCare constitutes an illegal tax, including violation of the Origination Clause.
AAPS is represented by Lawrence Joseph of Washington, D.C.
AAPS is a national organization representing physicians in all specialties. AAPS was founded in 1943.