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Thursday Dec 01, 2011

Preventing the Medicare Payment Cut

 The Joint Select Committee on Deficit Reduction's deadline for a budget compromise came and went without legislators issuing a plan that included a solution to the sustainable growth rate, or SGR, formula. In fact, the so-called supercommittee failed to come up with any plan whatsoever.

So where do we as family physicians go from here?

Beginning Jan. 1, Medicare payments to physicians will be slashed by 27.4 percent unless Congress intervenes. Although Congress has patched the SGR every year since 2003, time is running out. Both Houses are expected to adjourn by Dec. 21 at the latest, and legislators must still pass an omnibus appropriations bill and a tax bill in addition to dealing with Medicare.

House leadership has informed us that we should expect a Medicare proposal within the next few days. This could be a one- or two-year extension of the SGR with a 1 percent payment increase in each year, or it simply could be a short-term patch -- six months or less -- if legislators are unable to agree on offsets to pay for a longer extension.

The Academy has been advocating throughout 2011 for a permanent solution to the Medicare payment issueincluding a full repeal of the SGR and higher payment rates for primary care compared to non-primary care. I assure you that these vital points remain the AAFP's long-term goals.

In the short-term, however, it is paramount that we work together to avoid the looming 27.4 percent cut. When physicians were faced with a potential 25 percent cut at this time last year, nearly 13 percent of our colleagues said in an AAFP survey that they would consider closing their practices if that cut took effect. More than 60 percent of respondents said they would not take new Medicare patients in that scenario, and more than 70 percent said they would limit the number of appointments given to Medicare patients.

I know you are weary of this issue, but we simply can't allow this cut to happen to our patients and our practices. When the AAFP receives the House's Medicare proposal, I will be asking you, once again, to contact your legislators as quickly as possible and tell them to prevent the 27.4 percent cut. Please continue to make your voice heard.

Stay tuned for more on that grassroots effort.

If legislators do not act before the end of the year, it's conceivable that Congress could address the SGR retroactively in 2012. This possibility presents an impossible situation for physicians. We are actively communicating to Congress -- which doesn't reconvene after the holidays until Jan. 17 -- that this is not a reasonable or viable approach.

Your Academy leaders and staff are working around the clock to deliver our message to Congress, but legislators will need to hear from you as well. We'll be in touch soon with details about what you can do to help prevent the Medicare payment reduction.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.