Crisis looms: Medicare coverage doesn't pay enough, doctors refuse service, and Medicare patients can't make up the difference even if they want to.

• Author: Lavrakas, Dimitra

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When asked how many doctors offer their services to Medicare patients, Rita Hatch, Medicare Counseling Coordinator at the Older Persons Action Group in Anchorage, just shook her head and said, "It's a sad list.

"We do an ongoing survey of family practice doctors and internal medicine physicians because these are the doctors that seniors generally go to," she said. She keeps the list of providers close to her chest. "I don't publish it and the reason is because I don't want to burn out those doctors on the list," she said. "If someone calls, I'll give them the names of two or three doctors on the list, so they won't all burn out at once."

The State of Alaska Department of Health and Social Services houses the Senior and Disabilities Services (SDS), where anyone can contact the Senior Information Office. Within this office, the staff personnel have access to the Alaska Medicare Claim Administrator's database. More than 3,000 Medicare providers can be found within the State of Alaska. Visit http://www.hss. state.ak.us/dsds/SeniorInfoOffice.htm to look up a health care provider in your area.

THE "NEW" DILEMMA

However, you still have to call each provider to determine if they are taking any new Medicare patients. This published list of statewide doctors, physicians assistants or other health care practitioners are in the Medicare network as Medicare providers, said Essien J. Ukoidemabia, director of the Alaska State Health Insurance Assistance Program (SHIP) and the SMP project (the fraud, waste and abuse side of Medicare) that deals with Medicare.

While Hatch actively looks for doctors who willingly take Medicare clients, she has begun to search elsewhere. "What I've done is found nurse practitioners because there are no doctors, and a nurse practitioner can do anything a doctor can do," she said. "They can send you for tests, refer you to specialists and prescribe medications."

When asked why doctors refuse Medicare recipients, she is succinct.

"Medicare pays too little and doctors charge too much," she sighs. "If they (doctors) would only charge less and Medicare pay more." But Hatch also understands the doctors' frustration with Medicare, particularly its billing method.

BILLING ADDS TO PROBLEM

"If a nurse, when filling out the chart, makes a mistake on the first few things in the billing, then Medicare will kick it back and if they resubmit it with those corrected and there are other mistakes, then they (Medicare) send it back again," Hatch said.

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