It's Another One-year SGR Patch for Bickering Congress

AAFP Calls Out Legislators Over Missed Opportunity to Permanently Fix Flawed Formula

March 28, 2014 05:46 pm News Staff

The U.S House has passed yet another temporary fix to the controversial sustainable growth rate (SGR) formula for calculating Medicare payments, thus averting a major cut in payments for physicians, but leading the AAFP to call on legislators to finish their work on a permanent repeal. This time, the patch spans 12 months.

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"We call on congressional leaders to return to the table, find an agreement on unresolved issues, and pass an SGR repeal bill that preserves beneficiaries' access to care, stabilizes the Medicare physician-payment system, and helps ensure high-quality health care," said AAFP President Reid Blackwelder, M.D., in a March 26 press release.

The current three-month patch to SGR payments expires on March 31. Without congressional action, physicians face a potential 24 percent cut in Medicare payments. The initial three-month patch was enacted to give legislators more time to pass a bipartisan, bicameral bill that calls for repealing the SGR in favor of a payment method that would increasingly focus on paying for quality rather than the current fee-for-service system.

Although the bill has strong legislative support in both the House and Senate, it does not include a method for paying for the repeal, and partisan disagreements on payment methods led to a delay in passage, thus necessitating a further patch in the Protecting Access to Medicare Act of 2014(, which passed in the House yesterday. The Senate is expected to vote on the patch on Monday.

The legislation delays any cuts in Medicare payments to physicians until March 31, 2015. If passed by the Senate, this will be the 17th time that a temporary patch, or "doc fix," has been applied to overcome reductions in payments resulting from the SGR formula. The total cost of temporary patches during the past 11 years is an estimated $160 billion.

The Academy, which has actively advocated for a permanent fix for years, does not support the policy of patching the payment formula yet again. "Progress toward reforming Medicare's physician payment system has reached a disappointing impasse with the potential passage of a 12-month temporary fix rather than the bipartisan permanent solution to Medicare's flawed SGR formula," said Blackwelder.

"Congress' continuing failure to repeal the SGR perpetually threatens access to Medicare services for millions of elderly and disabled Americans and continues the cycle of expensive, temporary delays in reform to Medicare physician payments."

Because the latest temporary measure was so unpopular, the House took the unusual step of adopting the measure by voice vote on the floor without a roll call. Many House members who were opposed to the legislation were not in the chamber when the voice vote was taken and could not object, according to an article in Roll Call(

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