UPDATE: AAFP issues action alert to block Medicare pay cut

Use Speak Out to contact congressional representatives

posted 02.18.10

Yet another measure that would have delayed the pending 21.2 percent cut in Medicare physician payment has failed as the March 1 deadline nears. The latest attempt, which would have frozen fees until Sept. 1, had been included in a bill to create jobs, but the Senate stripped the Medicare provision out last Friday. With less than two weeks left before the cut goes into effect, AAFP is calling on members to tell their congressional representatives what this cut would do to their practices and their patients by using the Academy’s online Speak Out tool. For more and for the link to the action alert, read this AAFP News Now article.

March 1 deadline looms for Medicare physician pay fix

posted 02.11.10

Does this sound familiar? Doctors face looming cut in Medicare payments unless Congress acts soon. No, it’s not déjà vu. As of March 1, CMS is scheduled to cut physician payment for Medicare services by 21 percent, a move that would likely cause more physicians to limit care to seniors and refuse to accept new Medicare patients.

For years, physician groups have called for a permanent fix to the SGR, or sustainable growth rate, the formula CMS uses to set annual limits on Medicare expenditures, but Congress has failed to implement the change, opting instead for a series of short-term extensions. Congress tried to replace the SGR as part of the current health insurance reform effort, but the $247-billion price tag for the change forced lawmakers to remove it from the bill. Attempts to pass it as a separate measure failed as well, so as the original Jan. 1 deadline for the massive cut neared, Congress passed a two-month rate freeze.

Now with only a couple of weeks left in February, it is unclear how Congress will address the impending cut. Recently passed Senate rules, called “pay-as-you-go”, require lawmakers to counter any new or increased expenditure with cuts elsewhere in the budget, but lawmakers included an important exception. They left the ability to freeze Medicare physician fees through 2014 without having to make up the expense, leading to speculation that a five-year patch could be in play.

More recent reports out of Washington, D.C., claim that Democrats plan to include a Medicare payment freeze in a jobs measure, while the budget proposed by President Obama would freeze physician payments in the program for 10 years.

The American Medical Association has taken a public position that short-term suspensions of payment cuts are no longer acceptable. “In their view, Congress must permanently reform the SGR now,” said Kevin Burke, AAFP’s director of government relations. “The AAFP’s commission on governmental advocacy and the commission on quality and practice recommended that AAFP continue to advocate for a permanent fix, but not shun shorter-term efforts to prevent drastic payment cuts for physicians.” The AAFP Board of Directors is expected to formally consider that recommendation at its next meeting in April, but Burke said the Academy will follow the directive in the meantime. AAFP is also asking Congress to include a 10 percent bonus payment for primary care in whatever permanent or temporary payment legislation it approves.

Burke says the most likely scenario is that Congress will pass a provision to continue physician payment at current levels until at least Oct. 1, 2010, as part of the jobs bill recently introduced in the Senate. “The reason for this short-term fix is to give Congress some flexibility if it addresses payment reform in potential health reform legislation.”

Stay tuned to TAFP News for more developments as the deadline nears.