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SGR Dangles Over Fiscal Cliff

Joe Cantlupe, for HealthLeaders Media, December 20, 2012

The Sustainable Growth Rate formula , the scourge of physicians, detested by both Republicans and Democrats, may be on the brink of being eliminated if the Obama administration has its way, according to healthcare sources.

For years, major physician groups have sought to get rid of the formula, which has meant proposed payment declines for doctors. And ironically, government actions to avoid the so-called "fiscal cliff" may open the door to elimination of the SGR.

The White House has reportedly proposed to get rid of the SGR as among its plans for avoiding the economic effects of tax increases and spending cuts that will occur in January if current laws are not amended. 

The budgetary negotiations between President Obama and House Speaker John Boehner, R-Ohio have been intense, but inconclusive.

"Our antennas are up for stuff happening," Jeremy Lazarus, MD, head of the American Medical Association, said. "Obviously, we want the SGR repealed and we're pleased the president said that."  The AMA sent a letter to lawmakers Wednesday in which it called the stalemate "inexcusable."

The Sustainable Growth Rate formula has been established to control spending for physicians. Each year since 2003, Congress has passed a "doc fix" to avoid significant cuts. Such funding shortfalls were pegged at 27% for 2013. It has become almost a tradition for Congress to fill the SGR gaps, with many saying that lawmakers have "kicked the can down the road" on the issue.

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