Endocrine Insider
March 4, 2010

(See Full Issue)

Though both houses of Congress have voted to avert Medicare physician payment cuts temporarily through April 1, the Senate and House of Representatives have yet to address a long-term solution to the recurring problem imposed by the flawed Sustainable Growth Rate (SGR) formula.

On Thursday, February 25, the House passed HR 4691, which delays the 21.5 percent across-the-board reduction for 30 days.  The Senate failed to pass the bill before the cuts went into effect on March 1 but did approve HR 4691 on Tuesday, March 2.  In anticipation of a delayed fix by Congress, the Centers for Medicare and Medicaid Services (CMS) had notified its contractors to hold Medicare physician claims until March 12 to provide lawmakers time to pass legislation to stall or reverse the cuts to reimbursement.  As a result of CMS’ actions, physician payments for services provided on March 1 and 2 will not be subject to the 21.5 percent cut.

Senate Majority Leader Harry Reid (D-NV) and Senate Finance Committee Chairman Max Baucus (D-WY) introduced legislation on March 1—the American Workers, State and Business Relief Act—that includes a number of health-related provisions, including a provision to block the Medicare payment cut until October 1, 2010.  Unfortunately, the bill provides only a 7-month reprieve from the cuts rather than a permanent solution.  Debate on the proposal has begun in the Senate, although it is unclear when a final vote will take place.

Members of Congress need to hear from their constituents that another short-term fix is not enough and that a permanent replacement for the flawed SGR formula must be identified and put into effect.  Society members and their concerned colleagues are asked to contact their senators and representatives urging them to support efforts to find a permanent solution to the SGR. 

Senators can be identified by visiting www.senate.gov and choosing a state from the menu in the upper right hand corner of the homepage.  Representatives can be identified by visiting www.house.gov and entering the zip code in the upper left hand corner of the homepage. Talking points for conversations with senators and representatives are included below. 

• As a constituent and a physician, I’m asking for your support for efforts to identify and pass a permanent solution to the flawed Sustainable Growth Rate formula and address the 21.5% cut that physicians are facing.
• It is difficult for physicians to operate and grow their medical practices when they can’t be sure whether their Medicare payments in the next six months will support the expenses associated with the practice.
• This seriously impacts patients’ access to the care that they need and may force many physicians to stop treating Medicare patients.
• Please find a permanent solution to the flawed SGR to ensure that physicians are able to continue providing vital services to Medicare patients.