Urge Federal Lawmakers to Reverse Medicare Physician Payment Cut

The AAFP has issued a Speak Out Action Alert asking Academy members to contact their congressional representatives to urge them to reverse a 21.2 percent reduction in the Medicare physician payment rate called for under the sustainable growth rate, or SGR, formula. The cut went into effect on March 1.

"As a family physician, and one of your constituents, I am deeply frustrated and perplexed on behalf of my elderly patients and me," says the Speak Out alert. "Letting such a significant decrease go forward is no way for the government to run a major health program or for physicians to run their practices."

Even before the payment cut went into effect, CMS had instructed its contractors to hold Medicare claims for the first 10 business days of March. The agency's action has postponed the immediate effect of the 21.2 percent cut, while giving Congress more time to pass a payment patch reversing the reduction. By law, CMS cannot pay a Medicare claim until 14 days after receiving it.

But if Congress fails to act within the 10-day period, the cut will impact physician Medicare payment rates, making it critical for AAFP members to tell their senators and representatives to reverse the reduction.

AAFP leaders, meanwhile, will be meeting with key congressional members and administration officials, including HHS Secretary Kathleen Sebelius, during the week of March 1 to discuss Medicare physician payment rates and the SGR, among other issues.

AAFP President Lori Heim, M.D. of Vass, N.C.; Board Chair Ted Epperly, M.D., of Boise, Idaho; and President-elect Ronald Goertz, M.D., M.B.A., of Waco, Texas, plan to meet with Sen. Max Baucus, D-Mont., chair of the Senate Finance Committee, and Sen. Tom Harkin, D-Iowa, chair of the Health, Education, Labor and Pensions Committee. The AAFP leaders also plan to meet with Health Resources and Services Administration head Mary Wakefield, Ph.D., R.N., and U.S. Surgeon General Regina Benjamin, M.D., M.B.A., who is a family physician.

"I know that Medicare payment is only one issue that legislators are dealing with right now," says the Speak Out alert. "Health care reform, the economy and budget are of consuming interest to all Americans. Nevertheless, as a family doctor who is trying to get the best care to my older patients, I want you to know that not addressing this cut has a real and tangible effect on my practice."

Congress passed a measure last December that postponed the 21.2 percent cut until March 1. The House voted in support of a bill providing a temporary payment patch until March 31, but the Senate failed to act, allowing the cut to go through. The House and Senate now plan to take up a separate bill to address a short-term patch, and, as a result, Congress may not move on a temporary fix within the 10-day window. If this happens, the 21.2 payment cut would begin to impact physician payment rates.

In the past eight years, the SGR has triggered steep reductions in Medicare physician payment rates that have been averted only by last-minute congressional intervention.

"Unfortunately, the yearly fixes to Medicare payment already are having an influence on some family physicians," the Speak Out alert says. "We were sorry to see that the percent of family doctors participating in Medicare declined significantly from nearly 92 percent in 2008 to 87 percent in 2009."

Moreover, according to the Speak Out alert, the number of family physicians accepting new Medicare patients has remained the same over the past few years at 78 percent. "These are disturbing trends for an aging American population," says the alert.

This year, as in the past, the AAFP has led the fight against pending SGR payment cuts, rallying member support through a series of Action Alerts that also have called for a permanent fix to the SGR. In response, AAFP members have sent more than 9,000 messages to legislators during the past five months.