(Editor's Note: Lawmakers introduced bipartisan legislation(burgess.house.gov) in the House and Senate on March 19 to replace the Medicare sustainable growth rate formula, according to a press release from the House Ways and Means Committee(waysandmeans.house.gov). The AAFP issued a letter(2 page PDF) in support of the legislation.)
As the best chance in years builds this month for repeal of the unpopular Medicare sustainable growth rate (SGR), individual family physicians can make their voices heard before House and Senate lawmakers adjourn for the spring recess -- thanks to tools the AAFP has rolled out.
The AAFP and dozens of other medical organizations are urging Congress to act before March 31 to prevent a 21 percent Medicare payment cut. So far, Congress has staved off such cuts 17 times by temporarily overriding the SGR formula rather than repealing it.
The House is scheduled to consider a bill that addresses both the SGR and the Children’s Health Insurance Program next week. The bill was introduced last year and received support from an overwhelming majority of state and national physician organizations, including the AAFP.
"We applaud the reintroduction of legislation that will provide health security to millions of elderly and disabled Americans by establishing a stable system by which to pay physicians for their care," said AAFP President Robert Wergin, M.D., of Milford, Neb. "By passing this bill, lawmakers will stabilize Medicare, address the dual challenges of improved care and lower cost, and bring peace of mind to their elderly and disabled constituents."
- Observers say this month is the best chance in years for Congress to repeal the unpopular Medicare sustainable growth rate.
- The AAFP has rolled out tools to help family physicians make their voices heard among their congressional representatives who will consider repeal.
- Medical organizations are urging Congress to act before March 31 to prevent a 21 percent payment cut.
On March 19, the AAFP will host a virtual lobby day for members to take action. Family physicians who want to support SGR repeal should call their congressional representative using the toll-free number 1-866-629-5269 between 9 a.m. and 6 p.m. EDT. Callers will be asked to provide their location and will then be connected with their representative.
"I understand we have traveled this path many times before -- specifically, 17 times," Wergin said. "However, legislators that I spoke with indicated that the repeal of the flawed SGR formula can occur if enough of their colleagues hear from their constituents that this is a priority."
Once connected, callers should ask their representative to support legislation that would "repeal the flawed Medicare sustainable growth rate formula." After members complete the call, they can send another message through the AAFP's Speak Out tool.
In 2014, all of organized medicine supported bipartisan legislation that would have repealed the SGR and provided a clearly defined path to permanent payment reform. The bill would have encouraged changes in payment to improve the delivery of health care by supporting primary care. It also would have established a period of stability in Medicare physician payments and provided pathways for physicians to receive higher payments for practice and quality improvements.
Congress failed to pass the legislation because of disputes about how to pay for it. As a result, legislators resorted to another short-term extension of the SGR, often called a "doc fix," until March 31. Now, time is running short because the House will break for spring recess after March 26.
Since 2003, Congress has had to override the SGR formula 17 times. The total cost to Medicare for the short-term patches applied to date is estimated to be $169.5 billion.
A repeal of SGR was often discussed in the past, but the current climate represents the best and, possibly, the last opportunity for SGR repeal for the next three years. If full repeal is not achieved this time, Congress will likely enact its 18th short-term patch and physicians will endure three more years of an inequitable payment system that is mired in a fee-for-service structure and minimizes the value of primary care.
Family physicians are well aware of the negative impact SGR policy has on practices and know that a 21 percent cut could prevent them from being able to provide care to their Medicare patients.
On Monday, the AAFP signed on to a letter to House Speaker John Boehner(21 page PDF) urging him and other leaders to enact legislation repealing the SGR. Dozens of national and state medical organizations also signed the letter, which praised lawmakers for last year's bipartisan efforts to reach an agreement.
"Last year's efforts to reform the Medicare physician payment system far exceeded previous attempts to repeal the flawed SGR formula," the letter reads. "Through months of hard work, a policy was developed that won not only bipartisan congressional support but also widespread support from organized medicine."
Voices outside the medical community also are supporting repeal. In a March 15 editorial, the Wall Street Journal called for full repeal of the SGR. Acknowledging that the doc fixes have prevented the measure from ever being implemented, it noted the high cost of keeping the legislation in place.
"The practical result has been to disguise future spending from the federal budget and thus hide Medicare's true cost," the editors wrote. "Far better to end this cycle of fiscal deception and replace the SGR with more honest budgeting."
Related AAFP News Coverage
SGR Repeal Faces Uphill Climb, Say House Members