The ACP Advocate Blog
by Bob Doherty
Friday, April 16, 2010
The SGR Farce
Once again, Congress is playing with fire by not enacting a permanent solution to the Medicare SGR physician payment cut problem.
Congress got itself tied up in knots trying to figure out a way to reverse a 21% cut in Medicare payments to doctors that went into effect yesterday. It ended up agreeing to legislation, which was signed into law late Thursday evening by President Obama, to restore payments to the pre-cut (2009) levels through the end of May. The action, though, may have come a dollar short and day late: CMS has indicated that it had no choice but to tell carriers to begin processing claims with the 21% cut, starting yesterday.
Even though those payments will now be retroactively restored, it is ridiculous that physicians have had to deal with what ACP President Joseph W. Stubbs, MD, a private practice general internist himself, called the "chaos" created by Congress' dithering on the SGR.
Now, I know that some people are going to somehow try to pin the blame for this on "ObamaCare." But the truth is that even if health care reform had never seen the light of day, physicians would have been dealing with the 21% cut. And it is also a fact that the House of Representatives passed legislation this past fall, with the support of President Obama, to permanently eliminate the SGR and replace it with a system that would provide higher updates to all physician services.
The problem now is the U.S. Senate, where not one darn thing can get done if a single member objects - that is, without going through a series of procedural votes that require at least 60 votes.
ACP refuses to play the game of helping Congress get the votes it needs for a short-term reprieve. Instead, we are asking our members to tell Congress that the only effective outcome is throw out the SGR and replace it with a system that provides fair, stable and positive updates.
Yes, getting rid of the SGR will result in higher Medicare spending than if Congress allows the doctor fee cuts to go into effect. Some fiscal conservatives therefore object to a doctor pay fix because it will increase the deficit. But they should know that it is ridiculous to pretend that Medicare will save money from scheduled cuts that everyone knows will never take place.
It is the failure of both political parties, over many years, to honestly deal with the SGR, including the cost of getting rid of it, which has resulted in the current ongoing SGR farce. And yet members of Congress wonder why the public holds them in such low regard.
Today's questions: How will the SGR cut affect you? What are you telling your members of Congress?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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