Lawmakers Seek SGR Alternatives, But Who Will Pay?

Salgian is closely monitoring congressional actions. "Do I feel confident? We've doing this dogfight for 10 years," he says. "Frankly, how they are funding this now is like paying the minimum of a credit card bill."

The SGR isn't the only concern facing physician groups.

They are worried about the impact of the Independent Payment Advisory Board, which is scheduled to make recommendations on overall Medicare spending in 2014. The Patient Protection and Affordable Care Act established a 15-member IPAB to "extend Medicare solvency and reduce spending growth through the use of a spending target system and fast track legislative approval process," according to a House health subcommittee memorandum.

"Should the SGR remain in place when the IPAB takes effect, physicians will be subject not only to the SGR but to the further reductions in Medicare reimbursement based on IPAB's authority," Hoyt told Congress.

But that's another problem up the road, another potential headache. First things, first: the SGR.