After a tumultuous December, Congress will convene again in Washington, D.C., this month. Many health policy issues affecting the rheumatology community were left on the table at the end of the first session of the 112th Congress. The ACR will work diligently with key lawmakers and our supporters in Congress to address pressing issues affecting rheumatologists, including the following.
Explore this issueJanuary 2012
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SGR Cuts Take Effect This Month
Members of the congressional Joint Select Committee on Deficit Reduction failed to come to an agreement on how to cut at least $1.2 trillion from the nation’s budget. The ACR, along with state and specialty medical societies and the AMA, pushed the supercommittee to include a permanent solution to the Sustainable Growth Rate (SGR) in their final package. Upon the failure of the supercommittee to reach any agreement, lawmakers have a few short weeks to avert the scheduled 27% cut to Medicare reimbursements.
At the time of this writing, Congress was at a standoff over legislation that would prevent the 27% cut scheduled to take effect January 1. Should they find a solution, the legislation would be retroactive to January 1. The ACR does not support a short-term fix and will continue to urge Congress to identify a permanent, workable solution to the SGR and move past the current physician payment system. The ACR will also continue to work with our allies in the Cognitive Specialty Coalition to ensure the value of cognitive specialists in coordination of care and improving patient outcomes is recognized in any new physician payment models.
Funding for Medical Research at the NIH
Biomedical research plays a pivotal role in advancing diagnostics, treatments, and prevention strategies for patients with chronic diseases. Advancements in arthritis-related research have helped to prevent disabilities, allowing patients to continue or return to work and contribute to the U.S. economy. Research is imperative to the discovery of cures and development of new treatments for patients with chronic conditions. On December 16, Congress approved legislation for the FY 2012 spending package that included a $299 million increase for the National Institutes of Health. However, with Congress continually looking for ways to decrease the deficit and cut spending, the ACR will maintain its advocacy for continued investment in medical research.
Restrict Tier IV Practices
Insurers are increasingly moving vital medications and access to specialist doctors into specialty cost tiers. More and more, insurance companies are requiring patients to pay a percentage of the cost of specialty drugs—from 25% to 33%, or more—rather than a flat dollar copayment. Several states have attempted to address this growing problem through legislation. However, a federal solution is necessary to preserve access to treatments for patients who are self-insured with insurance plans that are not regulated by states. The ACR is preparing a legislative solution that would keep out-of-pocket expenses within affordable ranges, in order to ensure patient access to these critical therapies.
Repeal of the Independent Payment Advisory Board
The Affordable Care Act establishes a 15-member Independent Payment Advisory Board (IPAB) charged with recommending reductions in Medicare spending if spending exceeds a target growth rate beginning in 2014. The ACR is opposed to the creation of an unelected, unaccountable independent commission with the power to mandate payment cuts for physicians. The Medicare Decisions Accountability Act (H.R. 452), introduced by Rep. Phil Roe, MD (R-TN), would repeal the establishment of the IPAB. The ACR supports H.R. 452 and will be pushing for its passage this year.