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Physician Groups Call for an End to SGR Pay Formula


Medical groups are calling for legislation that will eliminate the sustainable growth rate formula used in calculating Medicare payment rates.

This article originally appeared on HCPLive.com.

In the ongoing battle to convince Congress to eliminate the sustainable growth rate (SGR) formula used in calculating Medicare physician payment rates, the American Academy of Family Physicians has joined the American Medical Association and scores of other medical groups in calling on House and Senate leaders to enact legislation this year that will accomplish that goal. At the same time, say the groups, Congress should lay the groundwork for the adoption of broader physician payment and delivery reforms.

“Last year, Congress was required to act five times to pass short-term measures (for as short as one month) to stop Medicare physician payment cuts scheduled for 2010,” stated a March 10 letter circulated by the AMA and signed by the AAFP and 130 other medical organizations and societies.

“On three occasions, Congress failed to act before cuts were implemented, causing disruptions in processing Medicare payments. These payment uncertainties and delays created serious problems for many physician practices and jeopardized seniors’ access to care.”

The letter, which was sent to Senate Majority Leader Harry Reid (D., Nev.); Senate Republican leader Mitch McConnell (R. Ky.); House Speaker John Boehner (R., Ohio); and House Democratic leader Nancy Pelosi (D., Calif.), acknowledges that, ultimately, lawmakers came to a bipartisan accord in passing the Medicare and Medicaid Extenders Act of 2010, which stabilized Medicare payments through 2011.

However, CMS now estimates that physicians will face a 29.5% reduction under the SGR on Jan. 1, 2012, unless Congress acts to block the cut, according to a statement from the AAFP. “It is our hope that Congress can again work together this year to end the cycle of temporary patches once and for all and develop a long-term and meaningful solution to this issue,” the letter stated.

In addition, the groups say, “The physician community is committed to taking a leading role in developing and pilot testing payment and delivery reforms that can provide a foundation for replacing the SGR and improving the Medicare physician payment system.

"We look forward to building upon last year’s bipartisan effort to permanently replace the SGR with a workable system that keeps pace with practice costs and ensures that seniors, the disabled and military families receive the high-quality care that they have been promised for years to come,” the letter concluded.

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