Congressional support to repeal the sustainable growth rate (SGR) program is growing. Some 114 members of Congress, including 21 Republicans, have signed a bipartisan letter to the Joint Select Committee on Deficit Reduction, asking the committee to repeal the unpopular Medicare physician payment system.
“We urge you to include a full repeal of the SGR, to stabilize current payment rates to ensure beneficiary access in the near-term, and set out a clear path toward comprehensive payment reform,” says the letter, which the signatories sent on Thursday to the 12-member “super committee.” “Failure to take advantage of this opportunity to permanently address the SGR means that the cost of a remedy over five years could double to nearly $600 billion.”
The letter notes that “for a decade, the fundamentally flawed Medicare physician payment system has created uncertainty and instability not only in the healthcare system but in the larger economy. Through this deficit reduction process, Congress has an historic opportunity to implement sound fiscal policy in the Medicare program in the context of broad economic reforms.”
It closes with a call for “bipartisan Congressional action to put an end to the fiscal irresponsibility that has defined Medicare payment policies for a decade. True deficit reduction cannot be achieved without addressing the significant debt in our nation’s largest health program.”
Rep. Allyson Schwartz (D-PA), a House leader on healthcare issues and the second-highest ranking Democrat on the House budget committee, organized the letter signing.
Members of Congress who added their name to the letter include Rep. Todd Akin (R-MO), Rep. Barney Frank (D-MA), Rep. Dennis Kucinich (D-Ohio), and Rep. Phil Roe, MD (R-TN).
The letter was sent on the very day that the Medicare Payment Advisory Commission voted to repeal the SGR and replace it with a plan that will include cutting reimbursements by $335 billion over 10 years. MedPAC, which advises Congress on Medicare payment matters, proposed that specialist reimbursement be reduced by 17.7% over three years and then frozen for seven years. PCP reimbursements would remain unchanged for the next 10 years. The remaining $235 billion in reductions would come from a combination of payment cuts to providers and health plans, including hospitals, Medicare Advantage plans, and durable medical equipment.
While asking for the repeal of the SGR, the Congressional letter offered only a vague statement on what might replace SGR: “The sustainable growth rate must be repealed and replaced by a payment system that promotes efficiency, quality, and value, and ensures access to medical services for Medicare beneficiaries.”
Tali Israeli, a spokesperson for Rep. Schwartz, says the congresswoman is concerned that MedPAC’s cuts are too severe. “There needs to be a smoother transition and more certainty in the future for the providers,” Israeli told HealthLeaders Media.
Schwartz is developing legislation to provide for an SGR alternative, but no details concerning what might be included in the potential bill are available. Israeli says it is doubtful that the legislation will be presented before the end of the year.
Time is of the essence. Congress has until October 14 to provide its recommendation on how to reduce the deficit to the debt committee. The super committee must vote on its debt reduction proposal by November 23, and Congress must vote on the debt committee proposal by December 23. If SGR is not repealed, a 29.4% cut in physician reimbursements will go into effect at the beginning of 2012.
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Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
