AGA Washington Insider

A policy blog for GIs

AGA Members Hit Capitol Hill as Congress Prepares to Move on Payment Fix

AGA is conducting an advocacy day with some of our young GI/trainee members to discuss the need for a permanent fix to the sustainable growth rate formula (SGR) and the need to continue to fund the CDC’s Colorectal Cancer Control Program. It turns out to be good timing for our physicians — the House may take up a tax extenders package that includes a five-year fix to the Medicare physician payment formula. 

The current proposal would prevent the 21.3 percent cut from being implemented on June 1 (Congress has already passed three short term patches to prevent this cut from going into effect) and replace it with a 2.2 percent update for the rest of this year and a 1 percent update in 2011. Beginning in 2012 through 2015, the SGR would be replaced with two spending targets — one for preventive services and evaluation and management, which would be updated at gross domestic product (GDP)+2, and all other services, which would be GDP+1. The plan would also establish a floor for the updates for the years 2012 to 2015 through which physician rates could not fall below zero. However, beginning in 2015, physicians would be faced with cuts of 30 percent. This plan remains very fluid and will be part of a larger tax package.

Earlier this year, the Senate approved paygo exemption legislation that would exempt paying for an SGR fix for five years, thus giving Congress $88.5 billion to fix the SGR that would not have to be offset. The House has similarly passed paygo exemption language that would permanently repeal the SGR, but this failed in the Senate. Although the AGA and all of organized medicine continue to press for a permanent fix to the SGR, getting a five year fix may be the longest fix that Congress will be able to pass and even that is not a given. Many members are now concerned with the cost of this legislation since its essentially $88.5 billion that is not paid for.         

AGA members will be meeting with their senators and representatives to urge Congress that they must fix the SGR this year. The American College of Physicians  will also be on Capitol Hill with 400 of their doctors urging Congress to fix this problem.

If the House is able to pass this package, the Senate would likely take it up late next week. The plan is to try to pass something before the end of May when the 21.3 percent cut goes into effect.

The AGA will continue to follow this issue closely and will provide updates via the AGA Washington Insider.

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