The law also creates an approval pathway for biosimilar biologics. The ACR believes that, while cost savings are highly desirable, the approval process for biosimilars needs to place safety and efficacy, supported by scientific sound evidence, as its highest priorities.
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Explore This IssueMay 2010
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The law hopes to increase the number of primary care physicians by increasing reimbursement to physicians who have a primary specialty designation of family medicine, internal medicine, geriatric medicine, or pediatric medicine. These physicians, along with nurse practitioners and physician assistants working in those areas, will see a 10% increase in their reimbursement if at least 60% of their services are provided as primary care services. Subspecialists have not been named in this section and therefore will not receive the increase.
Access for Medicare patients continues to falter as Congress continues to ignore the flawed sustainable growth rate (SGR) formula and costs for a permanent fix increase dramatically. Unfortunately, a fix for the SGR formula was not addressed in the new law. Physicians have had uncertainty throughout the year because Congress refuses to permanently repeal the flawed formula and continues to pass short-term fixes to Medicare reimbursement rates. This has made it impossible for physicians to run a practice with any certainty of their monthly gross income from Medicare patients. Several times CMS has held payments to physicians, allowing Congress more time to pass another band-aid. The time for band-aid fixes is now over. Physicians, health professionals, and patients must contact Congress to ensure that Medicare patients have access to care. With the baby boomers reaching Medicare eligibility, Congress cannot ignore the flawed formula and leave millions of Medicare patients without access to healthcare. Congress must fix the flawed SGR formula and guarantee appropriate reimbursement for physicians.
Healthcare reform is really just beginning. The law has been passed, but now the law must be implemented. The ACR will continue to advocate for physicians and our patients. We are staying abreast of the bill and know that as it unfolds we all will be trying to find access to care for the 32 million Americans who will now have healthcare insurance. To keep current on healthcare reform, I recommend you visit www.rheumatology.org.
Dr. Cohen is president of the ACR. Contact him via e-mail at firstname.lastname@example.org.