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Physician Groups Back Medicare Payment Reform Bill

John Commins, for HealthLeaders Media, October 15, 2009

Physicians' organizations are mounting a concerted campaign to roust support for a newly introduced bill in the U.S. Senate that would do away with the Medicare physician fee schedule under the sustainable growth rate formula.

"This legislation is going to move very quickly, so we need to act now to ensure that it passes," says Lori Heim, MD, president of the American Academy of Family Physicians. "Senators need to hear from physicians today on the importance of voting in favor of each of these procedural votes. Healthcare reform really does require that we address the flawed current formula for Medicare payments. This would give us the basis for that fix."

Budgetary rules require Congress to offset any increased spending for healthcare reform. The so-called Medicare Physician Fairness Act of 2009, or S. 1776 would reset the SGR formula to zero and eliminate the $245 billion debt that has accumulated during the past six years as a result of Congress' annual fixes to ensure physician payments were not reduced. AAFP says resetting the SGR debt will allow Congress to establish a new payment system based on quality of care rather than the quantity of procedures or services.

"S. 1776 would mean that Congress can finally recognize that the annual overriding of the reductions that the badly designed (SGR) formula generates is simply postponing the needed replacement of the payment formula," AAFP wrote in a letter to members. "It is critically important for Congress to face this responsibility and pass S. 1776 this week."

Before the bill—sponsored by Sen. Debbie Stabenow, D-MI—can reach the Senate floor, it must have at least 60 votes on each of three procedural votes, with the first vote expected on Monday.

"We need 60 'aye' votes on each of these steps so the full Senate can take up this bill. Without this legislation, we won't have a permanent payment fix, and we're facing a 21% cut in Medicare payment at the end of the year," Heim says.

A permanent repeal provision is already included in the House health reform bill.

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