Members of Congress who added their name to the letter include Rep. Todd Akin (R-MO), Rep. Barney Frank (D-MA), Rep. Dennis Kucinich (D-Ohio), and Rep. Phil Roe, MD (R-TN).
The letter was sent on the very day that the Medicare Payment Advisory Commission voted to repeal the SGR and replace it with a plan that will include cutting reimbursements by $335 billion over 10 years. MedPAC, which advises Congress on Medicare payment matters, proposed that specialist reimbursement be reduced by 17.7% over three years and then frozen for seven years. PCP reimbursements would remain unchanged for the next 10 years. The remaining $235 billion in reductions would come from a combination of payment cuts to providers and health plans, including hospitals, Medicare Advantage plans, and durable medical equipment.
While asking for the repeal of the SGR, the Congressional letter offered only a vague statement on what might replace SGR: “The sustainable growth rate must be repealed and replaced by a payment system that promotes efficiency, quality, and value, and ensures access to medical services for Medicare beneficiaries.”
Tali Israeli, a spokesperson for Rep. Schwartz, says the congresswoman is concerned that MedPAC’s cuts are too severe. “There needs to be a smoother transition and more certainty in the future for the providers,” Israeli told HealthLeaders Media.
Schwartz is developing legislation to provide for an SGR alternative, but no details concerning what might be included in the potential bill are available. Israeli says it is doubtful that the legislation will be presented before the end of the year.
Time is of the essence. Congress has until October 14 to provide its recommendation on how to reduce the deficit to the debt committee. The super committee must vote on its debt reduction proposal by November 23, and Congress must vote on the debt committee proposal by December 23. If SGR is not repealed, a 29.4% cut in physician reimbursements will go into effect at the beginning of 2012.