AAFP, Other Physician Groups Deliver Unified SGR Message to Capitol Hill

In a dramatic show of unity, AAFP leaders joined with their colleagues from other physician specialty organizations in pressing House and Senate members for a permanent Medicare payment solution during a series of Jan. 31 meetings on Capitol Hill.

AAFP Board Chair Roland Goertz, M.D., M.B.A., of Waco, Texas, and AAFP President-elect Jeffrey Cain, M.D., of Denver, along with representatives from the American College of Physicians (ACP), the American Osteopathic Association (AOA), and the American College of Surgeons (ACS), met with several key Republican and Democratic members of the House and Senate to push for a repeal of the sustainable growth rate (SGR) formula. Leaders from the AAFP and the other physician groups divided into two teams, making it possible for a physician representative from each organization to attend each meeting with legislators and their staff members.

Among those the teams met with were Senate Majority Leader Harry Reid, D-Nev.; Senate Minority Leader Mitch McConnell, R-Ky.; and House Minority Whip Steny Hoyer, D-Md., all of whom expressed an understanding of the problem and a desire to repeal the SGR. In their various meetings with House and Senate members and staff, the leaders of the AAFP and the other groups urged congressional members to repeal the SGR by using excess funds assigned to the Overseas Contingency Operations (OCO) accounts to pay for the cost of the repeal.

"I think we made history today in the sense that we had four of the largest physician groups in the country who represent physicians who take care of Medicare patients -- the AAFP, the AOA, the ACP and the ACS -- all on Capitol Hill with a unified message to fix the SGR," said Goertz.

The SGR has called for steep reductions in the Medicare payment rate during the past several years -- reductions that only have been avoided by last-minute action by Congress. In late December, Congress approved a bill that postponed for two months a 27.4 percent SGR reduction that was scheduled to take effect Jan. 1. Without congressional intervention, however, physicians will face a 27.4 percent cut on March 1. The AAFP has repeatedly called on Congress to repeal the SGR, and continues to urge its members to contact their representatives and senators in Washington via a Speak Out Action Alert.

The Capitol Hill meetings took place as a House and Senate conference committee meets in Washington to reconcile differences in House and Senate bills that would postpone the Medicare payment cut beyond the March 1 deadline. Accordingly, the AAFP and the other organizations specifically targeted members of the conference committee, meeting with eight of them and driving home the message that physicians are united in advocating repeal of the SGR.

In the various meetings, Goertz, Cain and the representatives from the other groups stressed that the conference committee has a unique opportunity to solve the long-standing SGR dilemma. The willingness of House and Senate members to meet with the AAFP and the other groups demonstrates how important the SGR issue has become on Capitol Hill, Goertz said.

"We met with as many conference committee members and staff as we could possibly fit into one day -- both Republicans and Democrats," said Goertz. "That is a successful advocacy visit."

In particular, Cain met with conference committee members Sen. Robert Casey, D-Pa., and Reps. Greg Walden, R-Ore.; Henry Waxman, D-Calif.; and Sander Levin, D-Mich. He also met with the staffs of Sen. Ben Cardin, D-Md., who also is on the conference committee, and House Minority Leader Nancy Pelosi, D-Calif., among others.

Goertz, meanwhile, met with conference committee members Sen. Michael Crapo, R-Idaho, and Rep. Tom Price, R-Ga., as well as with House Ways and Means Committee Chair Dave Camp, R-Mich., who also is chair of the conference committee.

In addition, Goertz paid a visit to the office of Senate Majority Whip Richard Durbin, D-Ill.

"We had unanimous agreement across the aisle that the SGR is broken," said Cain. "Both parties said they are trying to fix it."

However, congressional members do not agree on how to pay for an SGR repeal, which has prevented Congress from fixing the flawed payment formula. In their meetings with congressional members and staff, Goertz, Cain and the representatives from the other organizations explained how the SGR undercuts the practice of medicine by making it difficult for physician practices to plan for the future and to improve how they take care of their Medicare patients.

Cain pointed out that 95 percent of family physicians provide care to Medicare patients, making a 27.4 percent Medicare payment reduction devastating to family physicians. Cain also noted that Medicare rates determine TRICARE rates, meaning the SGR has an impact on uniformed services members, retirees and their families who are enrolled in TRICARE. Most of the House and Senate members were unaware of the relationship between Medicare and TRICARE, said Cain.