Medicare News: Low-income elderly squeezed by new rule

State to reduce co-pay for seniors on Medicaid


AUSTIN (KXAN) – Holding an X-ray to the light, Dr. Bruce Malone thought about the cost to replace the patient’s hip. If the $16,000 procedure happens in the New Year, he will have some tough decisions to make.

“It would be at least a $1,200 reduction in the payments to doctors for that,” Malone said.

Because of a historic state budget shortfall, the Texas Health and Human Services Commission changed its policy for a subset of Texans called “dual eligible.”

“Dual eligible” refers to the “poorest of the poor” – usually elderly – who qualify for both Medicare and Medicaid coverage.

“The most common thing I would do in a dual-eligible Medicare/Medicaid person would be fix a broken hip,” he said, hanging the X-ray back in its place at Austin Bone and Joint Clinic.

The changes take effect Jan. 1

Malone, a partner at the clinic, has been an orthopedic surgeon in Austin since 1977. He also is the president of the Texas Medical Association, which deals with doctors across the state. A top concern in the foreseeable future for that group is doctors soon having to choose between paying for what some patients cannot or turning those patients away altogether.

“No Medicare. No Medicaid. It would be a disaster,” he said, shaking his head, referring to Jan. 1, when the policy change goes into effect.


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