Doctors have been given at least a one-year reprieve until reimbursements for seeing Medicare patients are cut by 25 percent, thanks to a short-term fix approved Thursday by the House.

Since 2002, Congress has been using temporary fixes to delay the pay cuts, including the bill passed this week. Some of these measures lasted years, other lasted a month or two, but a long-term plan still hasn’t been introduced.

With 25 percent cuts, it’d be difficult for doctors nationwide to accept Medicare patients and still cover costs. On the Treasure Coast, where Medicare individuals can make up more than half of practices’ patients, doctors might not be able to take that kind of financial hit if the cuts go through. That could mean Medicare patients are hard-pressed to find doctors.

While cuts inched within a month of becoming effective Jan. 1, some local doctors stopped seeing new Medicare patients as a precaution.

“They need to stop with the Band-Aids,” said Dr. James Presley, who practices in Vero Beach. “We can’t really plan to take care of our patients when we’re always threatened with 25 percent cuts.”

Presley, like several of his peers, has held off accepting new Medicare patients since September. An obstetrician/gynecologist who also practices primary care, Presley said about 30 percent of his patients are on Medicare. With the latest bill, however, he’s started accepting new Medicare patients again.

If cuts are implemented, they could eventually drive small private practices — like his two-doctor, one-nurse practitioner group — into extinction because of high overhead costs and diminishing bottom lines, Presley said. Networks with upwards of 100 doctors might become the standard, he said.

The bill freezes Medicare rates for 2011 using $19.2 billion repurposed from a tax-credit program for health insurance buyers in the health care overhaul.

Since the private insurance market often mimics Medicare’s actions, it’s possible those rates could follow suit and drop too, Presley said.

About 65 percent of patients at Stuart Cardiology Group are on Medicare, said Dr. Joseph Gage. His practice doesn’t plan on cutting or lowering its base of Medicare patients. Instead, they’re trying to keep costs low and become more efficient, Gage said.

Using electronic medical records, more nurse practitioners and additional physician’s assistants can be proactive moves to face cuts that are likely inevitable, Gage said.

“We are sort of bound to Medicare,” Gage said. “The challenge is not to exclude patients with reimbursements lowered, it’s to lower costs and continue to improve our practice.”

If there are any hard feelings from his patients, they haven’t been directed at the doctors, Presley said.

“They were upset not with our practice, but with Congress,” Presley said.

Posted December 10, 2010 at 6:53 p.m.

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