SGR Reform Fails in Congress: MMS, AMA Vow More Repeal Efforts in 2015

Despite strong protests from much of organized medicine, last month Congress approved a one-year extension of the current Medicare physician payment formula.

The vote dashed hopes for a permanent repeal of the flawed sustainable growth rate formula, or SGR. The new legislation averts a 24 percent cut in Medicare payments, which was scheduled to take effect on April 1. For the rest of the 2014 calendar year, physicians will get a 0.5 percent increase. Rates will be flat for the first three months of 2015, at which time another cut is scheduled to take effect.

The SGR legislation also mandated a one-year delay of the implementation of the new ICD-10 diagnosis code set until Oct. 1, 2015.

The MMS, AMA, and many other medical societies vocally opposed the SGR patch, and had advocated for months for a complete repeal of the payment formula.

“We’re very disappointed that Congress has again failed to fix the deeply flawed Medicare payment formula,” said MMS President Ronald Dunlap, M.D. “The legislation is sound policy that was supported by both parties, in both chambers of Congress. Yet, because its leaders were unable to overcome partisan differences over how to pay for it, we now have the 17th SGR patch in the last 11 years.”

“The bitter irony is that every patch makes the problem worse. Congress could have solved the problem years ago by enacting a permanent repeal, and would have saved taxpayers tens of billions of dollars,” said Dr. Dunlap.

“The campaign to fix Medicare must continue, for the sake of the millions of seniors and military families who depend on the program for their health care. We’re deeply grateful to the members of the Massachusetts congressional delegation for their steadfast support for true Medicare payment reform, and pledge to work with them to achieve this goal — once and for all,” he said.

AMA President Ardis Dee Hoven, M.D., also expressed disappointment with Congress for its failure to permanently repeal the SGR.

“Congress has spent more taxpayer money on temporary patches than it would cost to solve the problem for good,” said Dr. Hoven. “This bill perpetuates an environment of uncertainty for physicians, making it harder for them to implement new innovative systems to better coordinate care and improve quality of care for patients.

“Remarkable progress was made this past year in reaching a bipartisan, bicameral agreement on policy to repeal the SGR, and the AMA encourages Congress to continue its work and resolve outstanding issues. On behalf of Medicare patients and physicians across the country, it is critical that we achieve permanent Medicare physician payment reform,” she said. “We will continue our efforts to secure a permanent SGR repeal this year.”

The MMS would like to thank the many physicians who contacted our congressional delegation to urge rejection of the measure.

Read a summary of the bill’s provisions and download the bill’s full text at www.massmed.org.

—Alex Calcagno
MMS Director of Federal Relations

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