As a result of the debt ceiling vote, a 12-member joint commission is charged with trimming at least $1.2 trillion in federal spending over the next decade. The so-called "super committee" is required to recommend the cuts by Nov. 23, and Congress would have until Dec. 23 to vote on the plan. If the committee can't reach an agreement, a 2% cut to Medicare providers would be made automatically.
Then there's the other, and more complicated fiscal issue, the SGR debacle, an annual crisis.
Once again, the SGR payment formula calls for deep reductions in Medicare payment rates, which has been continually delayed. Unless Congress intervenes, the SGR formula will mandate a 29.5% cut in the Medicare physician payment rate on Jan. 1. And once again, physicians say the reductions will drive doctors out of business or force them to stop seeing patients.
Nobody knows what will happen, of course, but it will be a very interesting fall and winter. Physicians are predicting one of the more vigorous lobbying efforts by their groups in sometime, with the ACEP discussions on Capitol Hill just a precursor of things to come.
The SGR is a far greater concern to physicians, says Roland A. Goertz, MD, MBA, FAAFP, president of the board of directors of the American Academy of Family Physicians. "We've analyzed this and 2% is the automatic rollback if the 12-member committee can't make a decision, or if Congress and the President can't agree," says Goertz, referring to the debt ceiling fallout. "Will 2% (reduction) make a difference? Well certainly, it will, but nowhere near the difference that the SGR would make at 29.5% if it's not dealt with."
"We are trying to make a case to have this 'fix' for five years, to put some sensibility into the system," Goertz says, referring to the SGR. He adds that it would be sensible if the super committee also addressed the SGR issue.