Keeping Our Eye on Reform in the Midst of Capitol Hill Chaos

Vital Signs: November 2013

Federal Update

Keeping Our Eye on Reform in the Midst of Capitol Hill Chaos

MMS Officials Believe 2013 Offers Best Opportunity to Eliminate SGR

The acrimony and discord in Congress over the Affordable Care Act, which led to the recent federal shutdown, has been tremendously frustrating to all of us who work in federal health care advocacy.

Yet this is the political environment in which we as a physicians’ organization will continue to advocate for those health care reforms critical to Massachusetts patients.

We expect that legislation to repeal and replace the Sustainable Growth Rate (SGR) for Medicare physician payments will be debated by the end of this year. Legislation emerged from a House committee that includes some of the main issues advocated by the AMA and many of the national medical and state organizations ― a period of stability for Medicare payments, direct physician involvement in developing new quality reporting requirements, and flexibility and choice for physician practices.

But some proposed legislation to reform SGR includes a number of troublesome provisions, including a lack of provisions to address how small, rural, and retiring physician practices will keep up with the new requirements that are envisioned. Nor does it reconcile the myriad of existing requirements and demands on physicians’ practices with the new ones proposed as part of the reforms.

An even bigger issue confronting those hoping to eliminate the SGR permanently will be how to pay for the new plan. In the past Congress has decreased funds for others, including hospitals, to stop the pending Medicare physicians’ payments cuts. Many of these groups have already announced their opposition to this approach again, which is of no surprise.

The MMS continues to believe that 2013 presents us the best opportunity we have seen to date to eliminate the SGR. The Congressional Budget Office this year scored the cost of eliminating the current program at about $130 billion, which is about $100 billion less than previous years.

And yet the challenges, both in terms of the political environment and the fiscal realities, will require an unparalleled advocacy effort from physicians, patients, and the health care community. We will, as always, keep you posted on our progress.

― Alex. Calcagno

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