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Statement on House Action on SGR Today

Statement attributable to:
Molly Cooke, MD, FACP
President of the American College of Physicians (ACP)

Washington, March 27, 2014 — Physicians and their patients need to know that today, by a voice vote—with no recorded votes and therefore no individual member accountability for their votes—the House of Representatives voted for the 17th short-term Medicare SGR patch over the past eleven years. By voting for the patch, the House failed to heed the unified call, of physicians who believe that now is the time for the House and Senate to reach agreement on the bipartisan reforms that were agreed to by the leaders of the Medicare committees of jurisdiction.

ACP is the largest medical specialty organization and second-largest physician group in the United States, representing 137,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum, from health to complex illness.

As we said yesterday in our letter, to the House leadership, we cannot support another short-term patch. Instead, we firmly believe that enactment of permanent SGR repeal and reform, this year, by this Congress, is both imperative and achievable, because never before has there been agreement between the members of the House and Senate, and between Republicans and Democrats, on the policies to repeal the SGR and create a better Medicare payment system.

The Protecting Access to Medicare Act of 2014 would be the 17th patch enacted over 11 years to temporarily halt impending SGR cuts, at a budget cost of over $150 billion. Each time, physicians and patients were told that, this time, things will be different, that the temporary patch would give Congress the time it needs to achieve agreement on permanent reform. Why should physicians and patients believe that passing another patch now would result in permanent SGR repeal?

This one-year patch, if passed by the Senate, will likely give Congress the out it wants to push the entire issue of permanent SGR repeal and Medicare payment reform to the 114th Congress. The new Congress would then have to start over on crafting a permanent SGR repeal and Medicare payment reform bill that could clear the authorizing committees, pass both chambers, and be signed into law by the President—before this latest proposed patch expires on March 31, 2015. It is more probable that this would result in the enactment of patch #18 at an additional budget cost of tens of billions of taxpayers' dollars and further destabilization of Medicare.

It doesn't have to be this way, though. The House's vote need not and must not be the end of the line for permanent SGR repeal in the 113th Congress:

  • ACP again calls on the Senate to vote against the patch and instead act on the bipartisan and bicameral SGR bills introduced by the leadership of the Senate Finance, House Ways and Means, and Energy and Commerce committees on February 6. We note that S. 2110 and S. 2157 have identical policies on SGR repeal and Medicare physician payment reform as laid out in the bipartisan and bicameral framework agreed to by the leadership of the authorizing committees
  • The Senate and House should then enter into direct negotiations on resolving their differences on how to address the budget impact of these policies, which will then have passed both the House and Senate, albeit with different approaches to the budget offsets.
  • This can and must be done as soon as possible, before the 24 percent cut scheduled for April 1 destabilizes payments and creates severe access problems. (Practically speaking, April 14 is when payments to physicians would be cut by 24 percent because Medicare policy is to hold claims for two weeks).

Today's unaccountable voice vote by the House of Representatives was a vote for the status quo, a vote to hold health care for seniors, military families, and disabled persons on Medicare and TriCare hostage to an inherently flawed and destabilizing SGR formula, year after year after year. It was a vote to preserve a wasteful payment system that rewards volume instead of value.

Yet it must not mark the end of the effort by the committed members of Congress from both parties, in both chambers, who have worked so hard over the past year to reach agreement on a bipartisan bill to permanently repeal the SGR and reform physician payments. It will not mark the end of ACP's efforts to press Congress to reach agreement on passing the bipartisan and bicameral SGR repeal bill that was agreed to by the leaders of the authorizing committees. Physicians and their patients will hold both the House and Senate accountable for delivering on permanent SGR repeal, this year, by this Congress. There will never be a better time.

About the American College of Physicians
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 137,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

Contact:
David Kinsman, (202) 261-4554, dkinsman@acponline.org

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