Congress Approves 12-Month Medicare Payment Patch

Measure Gives Physicians Reprieve From Constant Threat of Cuts

December 09, 2010 05:10 pm James Arvantes

Both houses of Congress have now passed a yearlong Medicare payment patch that effectively blocks an impending 25 percent reduction in the Medicare payment rate called for by the sustainable growth rate, or SGR, formula. President Obama is expected to sign the legislation shortly.

"Today's vote will temporarily end the series of short-term patches that have plagued doctors and their patients throughout 2010," said AAFP President Roland Goertz, M.D., M.B.A., of Waco, Texas, in a prepared statement. "It is, however, only one step toward a permanent solution to the flawed sustainable growth rate formula that threatens deep Medicare payment cuts and the financial viability of primary care physician practices."

During the next 12 months, the physician community and Congress must work together to put an SGR patch in place for three to five years that will include a differential payment for primary care physicians, Goertz stressed. This will give payment reform demonstrations enough time to produce the evidence that should underlie any permanent replacement to the current poorly structured formula, he added.

"We will continue to talk to the leadership at the White House and in Congress to help them better understand why a three-to-five-year payment patch is the next step to a permanent fix," said Goertz in an interview with AAFP News Now.

The Senate passed the Medicare and Medicaid Extenders Act of 2010( by unanimous consent on Dec. 8, and the House followed suit on Dec. 9. The legislation marks the fifth and longest physician payment patch enacted this year.

In his statement, Goertz warned that "family physicians cannot sustain practices in an environment with both stagnated Medicare payment and monthly or semi-monthly threats of deep cuts in Medicare (payment)." He alluded to a recent AAFP survey that indicates a 25 percent cut in Medicare payments would threaten elderly and disabled patients' access to needed health care.

Meanwhile, in a statement( released by the White House, President Obama said, "For too long, we have confronted this reoccurring problem with temporary fixes and stop-gap measures. It's time for a permanent solution that seniors and their doctors can depend on, and I look forward to working with Congress to address this matter once and for all in the coming year."

"I am encouraged by the president's statement," Goertz told AAFP News Now. "I am also relieved that Congress has recognized the importance of providing some stability for Medicare payment so that we will have time to work together to correct a deeply flawed payment system."

During the past several months, the AAFP has emerged as a leading proponent of a long-term SGR fix that would eventually lead to a more equitable payment system while providing a payment differential for primary care services. In August, the Academy unveiled a toolkit to help family physicians and their patients generate support for fixing the flawed payment system.

On Dec. 7, the Academy sent an Action Alert to AAFP members urging them to e-mail their congressional representatives to support the one-year payment patch and pave the way for a longer-term SGR fix.