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Doc Groups Respond Over Proposal to Extend SGR Delay Three More Years

Janice Simmons, for HealthLeaders Media, May 24, 2010

Several major medical groups are expressing mixed reactions about a congressional proposal to delay a 21% cut in Medicare reimbursements when the latest exemption to the sustainable growth rate payment cut runs out June 1. Under the measure inserted in HR 4213, the "American Jobs and Closing Tax," the SGR cut in Medicare payment would be delayed until 2014.

As proposed, the measure calls for a 1.3% increase for physicians beginning June 1, followed by a 1% payment update starting Jan. 1, 2011. For 2012 to 2013, the bill would use new payment targets from another bill (HR 3961), which passed the House last November: one would provide a conversion factor based on the gross domestic product, plus a 2% increase for primary care and preventive health services, while the other has a conversion factor of the GDP plus a 1% increase.

By 2014, the payment formula would go back to the SGR. A move earlier this week in Congress to stall the cuts for five years was dropped. A vote on the provision is expected in the House and Senate the last week of May.

Congress' move to delay "a looming Medicare physician payment cut will provide temporary stability for seniors and their physicians," said American Medical Association President J. James Rohack, MD, in a statement. However, the organization was "deeply disappointed that Congress will once again fail to permanently correct the Medicare physician payment formula that Republican and Democrat members of Congress, President Obama and policy experts have said should be repealed."

Writing in his blog on Friday, Rohack said that the newest proposal "treats the symptoms—it's not a cure for the disease" and that "Congress must act well before the next deadline to fix this problem once and for all to preserve access to care."

In his prepared statement, Ted Epperly, MD, board chair of the American Academy of Family Physicians said the new payment provision in HR 4213 "recognizes the importance of allowing for growth in the services provided by primary care physicians, especially if we are to respond to the increased demand for these services as more Americans get covered by insurance."

"The data are clear that healthcare based on primary care will be both more efficient and more effective," Epperly said. The pending legislation "builds on the recent efforts of Congress to recognize the value of primary care and provides stability of payment for several years."

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