Much at Stake for Rheumatology in Lame Duck Session of Congress

With the 2012 elections behind them, the current Congress still has major issues to tackle before the end of the year and the beginning of the 113th Congress in January. While one key issue—funding the government—was handled by a six-month continuing resolution back in September that ensures the federal government will remain open at least through March 2013, several key items remain unresolved.

What is at stake for rheumatology as year closes?

Unless the current Congress takes action to prevent them, massive mandatory spending cuts, or sequestration, are scheduled to go into effect in January, along with a nearly 30% cut to Medicare physician reimbursement and the expiration of several tax provisions. The most threatening cuts scheduled to go into effect on January 1 are:

• A 30% Sustainable Growth Rate (SGR) cut to physician reimbursement;
• A 2% sequestration cut to physician reimbursement; and an
• An 8% sequestration cut to NIH funding.

Sequestration cuts would directly affect rheumatologists who see Medicare patients with a 2% cut to reimbursements, on top of any SGR cut, and would also impose massive cuts to the budgets of agencies like the NIH. The agency has said that the scheduled 8% cuts would affect every area of its programs, including rheumatology-related research.

Additionally, while a small number compared to the cost of continuing expiring tax policies and preventing other cuts, the cost to postpone drastic SGR cuts to Medicare physician reimbursement is $11 billion. Lawmakers have heard from ACR members this year about the critical need to prevent these cuts, and they must continue to hear from you that preventing these cuts is a paramount priority, so that patients’ access to the specialty care they depend on is not threatened. We cannot take for granted that the SGR cuts will again be averted at the last moment. If you haven’t gotten a message to your lawmakers about preventing these cuts, do so now by using the ACR’s Legislative Action Center at www.rheumatology.org/advocacy.

After the cuts are prevented, the ACR will continue to work with lawmakers and other medical societies for a permanent repeal and replacement of the SGR formula. We will continue to push for physician payment reform that takes into account the particular needs of the rheumatology subspecialty. When the time comes to finalize details of a long-term reform plan, the ACR and its members will be well positioned to influence the plan.