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Time to fight again – for SGR repeal and a long-term Medicare solution
e-Reports, Sept. 6, 2011
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Help the ISMA, AMA prevent a loss to Indiana of $520 million in elderly, disabled care and $38,000 in practice revenue per Hoosier physician Untitled document

September dawns, another year winds down and a familiar task awaits physicians. Again, we must unite to halt a Medicare rate cut, this time nearly 30 percent, looming for Jan. 1, 2012. Last year, a 25 percent reimbursement cut was halted in the final hours.

“We knew we would be here again,” said Mike Rinebold, ISMA’s director of Government Relations. “In a few short months, we will face a potential access problem for Medicare and TRICARE patients, and this time, the congressional calendar is already full.”

Yet, timing adds greater urgency to the problem this year. The “super” joint committee established under the recent debt ceiling legislation is tasked with finding $1.5 trillion in deficit reductions. Medicare reimbursement may be targeted as one source of savings, and committee members must submit their recommendations by Oct. 14.

The ISMA needs your help. In less time than it takes to brush your teeth, you can boost our efforts to show Congress what will happen if Medicare pay is cut 29.5 percent.

Take the brief survey you’ll find here. Results will provide data to support our position and help paint a picture of exactly how the Sustainable Growth Rate (SGR) formula could affect Hoosiers next year.

Communicate with Congress
Only Congress can avert the potential cut and eliminate the formula that leads to this annual crisis. Make sure our senators and your congressional representative know how the threat from the SGR impacts you and your practice – year after year. Help them understand how your patients depend on the Medicare program, explaining that 29 percent of our state’s Medicare beneficiaries live below 150 percent of the federal poverty level.

Tell Indiana’s congressional delegation that a plan exists to remedy the situation. The AMA has proposed a three-pronged approach that involves:

  1. Repeal of the failed SGR formula
  2. Implementation of a five-year period of stable Medicare physician payments with positive updates
  3. Transition to some new payment structures

The ISMA joined the AMA and 111 other state and medical specialty societies in sending a letter to the president, vice president and congressional leaders urging inclusion of Medicare SGR reform in any deficit reduction plan. A permanent fix, not another band-aid delay, is now critical.

Since 2002, Congress has intervened 12 separate times to stop physician rate cuts in the Medicare program. Not one time did Congress approve the necessary funding to reform the SGR formula, universally judged to be fundamentally flawed. The resulting instability threatens the availability of care not only for the elderly and disabled, but also for military families under TRICARE.

A “huge problem”
U.S. Representative Larry Buschon, M.D., from Indiana’s 8th District is an ISMA member fighting for Medicare reform. “He needs our support,” said Rinebold. “Time is running out to make changes.”

As a physician, Rep. Buschon knows the Medicare program will run out of money in a few years and is shining the spotlight on the issue. At a roundtable discussion Aug. 17 in Terre Haute, he called the situation a “huge problem” for our nation.

Find out how to contact Indiana senators and representatives on the ISMA website. Or call the Government Relations staff at (800) 257-4762 or (317) 261-2060.

Key deadlines:

Oct. 14:
Regular House and Senate committees submit recommendations.

Nov. 23: Joint committee on debt reduction votes on legislation.

Dec. 2: Joint committee sends an approved bill to president, House and Senate.

Dec. 23: Congress votes on joint committee's bill.

Jan. 1, 2012: Medicare physician pay is cut by 29.5% unless Congress intervenes.

Source: Budget Control Act of 2011
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