SGR SIDEBAR: Here We Go Again!

Elizabeth McNeil

Note: The following is excerpted from the latest Federal Government Relations Update for the CMA board of trustees.

ON THE HEELS of one of the most maddening Congressional sessions in history, angry yet determined CMA physician leaders will return to Washington to once again push Congress to pass the bipartisan, bicameral Medicare SGR repeal and payment reform legislation.  

This last Congress has been appropriately labeled “The Worst Congress Ever” for their permanent state of acrimony and lack of productivity which has brought them, the Medicare program and even the United States government to the brink of collapse.  

Congress neglected or failed to reach agreement on hundreds of significant issues that need to be addressed immediately—including important health care issues, such as the Medicare SGR, the Medicaid Primary Care Rate Increase and Graduate Medical Education.

While this was not the first time Congress failed to repeal the SGR, it was particularly frustrating because they were so close to enacting a comprehensive Medicare payment reform bill that had bipartisan, bicameral support as well as the support of nearly every physician group within organized medicine. It was the most progress Congress had made in a decade. However, that progress came to a halt when they failed to reach agreement on the funding sources, known as “offsets.” Instead, they passed another temporary patch (the 17th patch in a decade) to prevent the larger SGR payment cuts. What’s even more frustrating is that the 17 patches now cost more than the total cost of the permanent SGR repeal legislation. Continuing to patch the SGR is not fiscally responsible!

CMA President Dr. Luther Cobb was in Washington, DC, during the Lame Duck session urging Congressional leaders to get the SGR bill passed once and for all. But Congress fell short once again, diverting all of their limited time and attention to the bitter debate over the President’s immigration order.  

Where do we stand in 2015?  
The good news is that both the Republican and Democratic Congressional leadership tell AMA and CMA that they continue to support the comprehensive Medicare SGR bill from last session. This bill will be the starting point for negotiations in 2015. The only remaining work is to identify funding sources that both sides can agree upon.  

There is also growing support for the notion that the SGR repeal portion of the bill does not need to be fully offset with other funding sources. Many conservative organizations—such as the Wall Street Journal, the Galen Institute and Americans for Tax Reform—have recently opined that because Congress consistently stops the SGR cuts, the SGR will never go into effect and therefore, the cost of getting rid of it should be $0. This would reduce the cost of the bill by about $120 billion and only require Congress to find another $80 billion to fund the new physician payment systems and a package of Medicare “extenders.”  

Timing
The next 24% SGR payment cut occurs on April 1—no joke. AMA, CMA and all of organized medicine will join forces to urge Congress to adopt the permanent repeal legislation before March 31. We plan to put a lot of pressure on the leadership.  

As we get closer to the deadline, we will be asking all physicians to call and email their Representatives. We will need a loud, large volume of calls to Congress in March.

So hang on . . . here we go again!

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Ms. McNeil is vice president for federal government relations at the California Medical Association.