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The Boston Globe

Opinion

jeff jacoby

A free market will help fix health care

Neurologists are about to feel the sting of the Affordable Care Act. Beginning Jan. 1, Medicare will be paying them less for electrodiagnostic procedures used in identifying and treating a wide range of nerve and muscle disorders. Reimbursement rates for some tests will be slashed by more than 50 percent, and the Centers for Medicare & Medicaid Services estimates that payments to neurologists overall will shrink by 7 percent next year.

Medicare’s cuts will be implemented by changing the way fees for the diagnostic procedures are calculated. Instead of reimbursing neurologists for each nerve analyzed, the new billing codes will henceforth bundle multiple nerve-conduction tests into a single fee. The Obama administration claims that under the current system Medicare has been paying too much for neurologists’ overhead costs. But the American Academy of Neurology, in an advisory to its members, warns that the cuts will devastate “neurology practices large and small.” Patients will be hurt as well: As Medicare squeezes neurologists, seniors’ access to neurological care will dwindle.

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