Medicare SGR Patch Tied to Controversial Social Security Payroll Tax Cut Bill December 12, 2011 Advocacy, CMA, Medicare, Payment, Politics and Medicine Grassroots Advocacy, Medicare, SGR, sustainable growth rate 0 Congress continues to work to form an agreement on stopping the 27.4% Medicare sustainable growth rate (SGR) fee-for-service program cuts before they take effect on January 1, 2012. Both the Republican and Democratic leaders in the House and the Senate have publicly said they are dedicated to stopping the Medicare fee-for-service payment cuts before the end of session. It is one of their top priorities and will be included in a large legislative package to extend the Social Security payroll tax cut and unemployment insurance benefits. House Legislation [caption id="" align="alignright" width="279" caption="A blog post from Boehner's office says everything in the bill is paid for through spending cuts rather than tax increases. Photo credit: AP"][/caption] The House Republican leaders unveiled the House legislation on December 9. Among many other things, it would stop the Medicare SGR fee-for-service payment cuts for two years and provide a 1% update in both 2012 and 2013. It also requires the Medicare Payment Advisory Commission (MedPAC), Government Accountability Office, and U.S. Department of Health and Human Services to make recommendations to Congress on long-term alternatives to the Medicare SGR physician payment system. There is also a relaxation of the restrictions on existing physician-owned hospitals. The legislation will be voted on in the House tomorrow, December 13. Proposed funding sources The bill provides funding sources from the Patient Protection and Affordable Care Act (ACA) including cuts to government subsidies to buy health insurance for individuals whose income level increases during the same fiscal year, as well as cuts to the ACA public health and prevention fund, which SFMS/CMA are strenuously opposing. The proposal would also raise Medicare premiums on individuals making more than $1 million. It reduces Medicare payments for E&M services provided in hospital outpatient settings to the same level those services are reimbursed in physician offices. And, it reduces payments to Disproportionate Share Hospitals, which the hospitals strongly oppose. Timing and process At this point, the Medicare SGR is being solely negotiated out of House Speaker John Boehner’s office with the Senate leaders and President Obama, and is tied to the outcome of the Social Security payroll tax cut deal. Voting on this legislation could come as early as December 13. Most expect it to pass the House; however, the bill faces stiff opposition from both Republicans and Democrats in the Senate. The opposition to the proposal is related to some of the funding sources, the limited extension of unemployment benefits, the changes in funding for the Social Security Trust Fund, and the inclusion of the controversial Keystone XL oil/gas pipeline across the Midwest. Senators are not, however, opposed to the Medicare SGR provision. Negotiations continue this week The Senate is expected to vote down the House Republican plan on Thursday, which will spur another round of negotiations. Congress is set to adjourn on Friday, December 16, but the leadership has said they will hold session through the following week until they reach an agreement. SFMS/CMA are working to obtain assurances from the California House Republican leaders and Senate offices that if the payroll tax deal goes down, they will still address the SGR cuts in separate legislation before they go home for the holidays. If the negotiations totally blow up, the Senate may try to run a Continuing Resolution (CR), which will include a stop-gap on the Medicare SGR cut. However, as controversial funding sources are negotiated out of the bill, that could reduce the length of the SGR stop gap from two years to one year, or change the payment increase. Moreover, there is a chance the rancor could stall all legislation, which means physicians could be hit with a 27.4 percent cut until Congress returns in January. As the Congressional bargaining continues, California physicians should know that Congressional leaders are working as quickly as possible to stop the Medicare SGR fee-for-service payment cut. However, politics over the larger issues is hindering a resolution to the Medicare SGR cut. SFMS/CMA will remain vigilant in keeping the pressure on our Congressional delegation and leaders to ensure the Medicare SGR cut is stopped as soon as possible – and for as long as possible. We have told Congress that these cuts will have a drastically negative impact on physicians and their patients, and that they cannot go home without stopping them. We have also been clear that a retroactive stoppage in January would be disastrous. Physicians should not be forced to finance the Medicare program on their backs because of Congress’s irresponsibility. Please help to keep the pressure on Congress to stop the Medicare fee-for-service SGR payment cut! Contact your legislator today! Please use the AMA hotline at (800) 833-6354. Enter your ZIP code and it will automatically connect you to your Representative. Please call the hotline again to reach Senators Boxer and Feinstein. You can also send emails via https://writerep.house.gov, www.boxer.senate.gov and www.feinstein.senate.gov. The sheer volume of calls is important so Congress knows you are watching closely and they must act. Tell your Representatives and Senators Boxer and Feinstein that: The Medicare SGR cut must be stopped before the end of the year. The cuts will harm access to care for 5 million California seniors. The cuts will wreak havoc on physician practices. Congress should not go home and think it’s OK to stop the cut retroactively in January. Physicians should not be forced to finance the Medicare program because of Congress’s irresponsibility. Click here for more coverage on the SGR bandage. Comments are closed.
