It’s not quite light at the end of the tunnel, but the incoming chair of the American College of Rheumatology’s Government Affairs Committee is “optimistic” Congress can permanently fix the way Medicare reimburses physicians and other health care professionals.
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By a 51–0 vote, the House Energy and Commerce Committee in July passed H.R. 2810, legislation that would repeal the Sustainable Growth Rate (SGR) formula. The bill has 40 sponsors, including 28 Republicans and 12 Democrats.
“It’s exciting. This is the closest we’ve ever gotten to a permanent fix. It’s the first time a permanent fix has ever made it through a committee. That, in and of itself, is very exciting,” says William Harvey, MD, MSc, of the division of rheumatology at Tufts Medical Center in Boston. “I’m as optimistic as I’ve ever been. However, this is the least productive congress since the 1940s. They just aren’t getting a lot of stuff done.”
The SGR has for a decade drawn criticism due to the fact it expires every year and Congress routinely “kicks the can” down the road with temporary fixes to avoid cuts to physician payments. This January, for example, physicians face an almost 25% reduction in Medicare payments.
“We are all very frustrated with the impending doom every January when the fix is set to expire,” says Dr. Harvey, an ACR board member. “The majority of our practices are small businesses, by definition, and no other small business in the country has to contend with not knowing if they will take a 25% drop in their revenue next month.”
Dr. Harvey says a Congressional Budget Office report earlier this year cut the estimated cost of fixing the SGR in half. However, the new legislation would implement automatic, 0.5% increases for at least the next five years.
“That is a lot better than a 25% cut, however, it’s not even close to inflation rate,” he says, adding his committee is going to make the bill a key issue during the Sept. 9 Advocates for Arthritis visits to Capitol Hill. “The remaining pay-for is where the bi-partisanship is going to disappear, most likely. Part of our job is to convince legislators that this is so important that it transcends the politics of where the money comes from.”
Richard Quinn is a freelance writer in New Jersey.