AAFP, Other Groups Push for SGR Repeal Before Congress Adjourns

November 25, 2014 04:03 pm News Staff

A new session of Congress is set to begin in a few weeks, but the AAFP and other medical organizations are hoping that in its final days, the 113th Congress will repeal the sustainable growth rate (SGR) formula used to determine Medicare payments.

[AAFP Advocacy]

Hoping to capitalize on widespread sentiment among current members in both chambers that the time to eliminate the SGR is now, the Academy was one of dozens of physician and other health care professional and advocacy organizations that signed on to a recent letter(3 page PDF) to House and Senate leaders urging them to do away with the fatally flawed formula.

"As you are well aware, Congress has struggled with the threat that the SGR formula poses to reimbursement for physicians and other health professionals and to access to care for seniors and disabled Americans," says the letter, referring to the ever-increasing Medicare payment cuts mandated by the formula.

Since 2003, Congress has enacted 17 short-term patches to forestall the cuts, most recently in March, when it passed a one-year stop-gap measure. Absent further congressional action, scheduled Medicare cuts for the coming year amount to 21.2 percent and would take effect on April 1.

In their letter, the AAFP and the other groups applaud Congress for having developed bipartisan, bicameral legislation to repeal the SGR earlier this year. The bill, known as the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, calls for a 0.5 percent annual increase in Medicare payments for physicians until 2018. It has not yet passed, however, because lawmakers have been unable to agree on how to fund the measure.

"Unfortunately, while Congress has long debated and acknowledged the flaws of the SGR formula, these repeated short-term patches leave health care providers uncertain about payment rates they will receive year after year," the letter notes. Eliminating the SGR would enable physicians to make long-term practice changes such as transitioning to a medical home model because they could rely on a consistent Medicare payment structure.

"We note that far more federal dollars have been spent through these short-term patches than what would have been spent if long ago the formula had been addressed permanently," say the groups in their letter.

The latest Congressional Budget Office estimate for complete repeal of the SGR with a 10-year freeze on payments is $119 billion -- a figure that is expected to rise if lawmakers cannot come to consensus on permanent repeal legislation.

Members can easily send a message to their representative or senator calling for repeal of the SGR using the AAFP's Speak Out grassroots advocacy tool.

Related AAFP News Coverage
It's Another One-year SGR Patch for Bickering Congress
AAFP Calls Out Legislators Over Missed Opportunity to Permanently Fix Flawed Formula