Passage of Medicare Bill Averts Deep Cuts in Physician Payments

The Senate has passed an 18-month Medicare physician payment bill that negates steep reductions in the Medicare physician payment rate for the remainder of this year and next year. The legislation now will go to President Bush.

H.R. 6331 (at the THOMAS Web site, type "H.R. 6331" in the search box after selecting "Bill Number") maintains current Medicare payment levels for the rest of 2008 and provides a 1.1 percent increase in the Medicare payment rate in 2009, thus negating a 10.6 percent payment reduction that took effect on July 1 and an additional 5.4 percent reduction that was scheduled to take place in 2009.

Bush has threatened to veto the legislation, but both the House and Senate now have passed the bill by veto-proof margins, making it likely that Congress can override a presidential veto.

"We are extremely pleased with the outcome of the vote and the efforts of family physicians who communicated with their senators about the importance of passing this legislation for Medicare beneficiaries, " said AAFP President Jim King, M.D., of Selmer, Tenn., in an interview with AAFP News Now. "With an 18-month update, Congress will now have time to develop an alternative to the flawed SGR (sustainable growth rate) formula."

This is the second time in less than two weeks that the Senate addressed H.R. 6331. Senate supporters of the measure could not muster enough votes to bring the bill to the Senate floor for a vote before adjourning for a weeklong July 4 recess on June 27. As a result, a 10.6 percent payment cut took effect July 1. Senate Majority Leader Harry Reid, D-Nev., brought the bill back to the Senate floor for a vote on July 9, and this time, the bill passed by a large margin.

King credits the grass-roots efforts of the medical community in general and the AAFP in particular for pushing the bill through Congress. The Senate vote represents a triumph for family medicine, perhaps signaling a turning point for the advocacy efforts of family physicians and their patients, who deluged Senate offices with e-mails and phone calls urging support for the legislation, King said. In the final analysis, nine senators who originally opposed the measure ended up supporting it.

"We have broken through the glass ceiling," King said, in reference to the AAFP's advocacy efforts.

Medicare relies on the SGR formula to determine Medicare payment rates. During the past several years, the SGR has triggered steep reductions in the Medicare payment rate that only have been averted by last minute-congressional intervention. In December, Congress passed a six-month payment update postponing an impending 10.1 percent reduction in the Medicare payment rate until July 1.

During the next 18 months, the Academy will be working closely with members of Congress to develop an alternative to the SGR formula.