AMA Takes Issue With Plan To Avert Medicare Reimbursement Cuts
On Tuesday, American Medical Association officials said the group opposes a plan that congressional leaders reportedly are considering to increase physicians' Medicare reimbursements by 1% to 2% over the next several years, before a 37% cut to the payments in 2015, CQ HealthBeat reports.
The five-year "fix" is one provision being discussed for the so-called "extenders" package (HR 4213), which House leaders expect to begin debating this week (Ethridge, CQ Today, 5/18). The package also seeks to extend unemployment benefits and subsidies to help purchase COBRA coverage.
A summary of the legislation circulating among lawmakers describes the plan as a way to avoid a 21% cut to Medicare physician reimbursements scheduled to take effect June 1. The summary also says that bill would include changes to the current Medicare physician payment system (Pecquet, The Hill, 5/18).
Last month, Congress approved a bill (HR 4851) that delayed the 21% payment cut until May 31 (California Healthline, 5/14).
AMA Concerns
A major issue for AMA members is the sustainable growth rate formula, which determines cuts or increases to Medicare reimbursement rates based on what the program paid physicians in previous years (CQ Today, 5/18).
In an e-mail to members, Kenneth Hopson of AMA's Division of Federal Affairs wrote, "Based on conversations with policymakers, [AMA] cannot support [the five-year fix] to address the flawed Medicare physician payment formula."
Hopson added, "The result in five years would be steeper cuts for physician practices, making it much more difficult, if not impossible, to achieve the objective of permanently repealing the sustainable growth rate" formula (The Hill, 5/18).
AMA President J. James Rohack estimated that waiting until 2015 to repeal the SGR formula could cost $500 billion, or more than twice of what it would cost to do so now (CQ Today, 5/18). He said, "Any temporary patch hasn't fixed the problem unless [lawmakers] fix the problem permanently."
Democrats, Republicans Disagree on Plan Viability
Democrats are seeking a five-year delay to Medicare cuts but have not yet found ways to offset the cost of such a solution and attract enough Republican support to pass the measure (Walker, MedPage Today, 5/18).
At the same time, members of both parties on the House Ways and Means Committee and the Senate Finance Committee, who have been negotiating the elements of the "extenders" package, are divided over the feasibility of a five-year fix (CQ Today, 5/18). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.