American College of Physicians (ACP) Expresses 'Profound Disappointment' About Congress's Failure to Act on Medicare and Medicaid Payment Policies

Attributable to:
David A. Fleming, MD, MA, MACP
President of the American College of Physicians (ACP)

December 11, 2014

(Washington) - Historians are likely to label the 113th Congress as perhaps the least productive ever, as it has compiled an unprecedented record of failing to address the key challenges facing our country. Regrettably, improving healthcare will be among the many issues where Congress has failed to act.

Specifically, it is now evident that Congress will, within a few days, adjourn without enacting legislation to repeal the Medicare SGR formula or to reauthorize the Medicaid primary care pay parity program.

This is not the first time that Congress has failed to enact legislation to repeal the Medicare SGR formula, of course, but it is particularly frustrating this time around, because Congress was so close to enacting a bipartisan and bicameral (House and Senate) bill to permanently repeal the SGR and make other improvements in Medicare payment policies. Both parties had agreed to such a bill earlier this year, but they couldn't agree on how to pay for it. So, instead, they passed another temporary "patch" to prevent an SGR payment cut that would have gone into effect on April 1-their 17th patch over the past 11 years! This patch will expire on March 31, 2015, at which time the SGR is scheduled to cut physician payments by another 21 percent.

Even so, despite the patch, the American College of Physicians did not give up on getting full SGR repeal in the 113th Congress, as it continues to press Congress to enact the bicameral and bipartisan SGR repeal bill in the current post-election "lame duck" session. We now know, though, that they will end the year without doing so, to our profound disappointment.

This must not spell the end, though, of the effort made by so many members of Congress and their staff members, with the support of ACP and many others, to reach agreement on policies to replace the SGR. The bipartisan, bicameral SGR repeal bill agreed to earlier this year included several ACP priorities in addition to SGR repeal: creating positive payment incentives for physicians who practice in Patient-Centered Medical Homes; simplifying and harmonizing Medicare reporting programs (including removing scheduled penalties under those programs); and many other improvements. We fully expect that this bill will be considered by the new 114th Congress next year, and we will redouble our efforts to get Congress to act upon it before the current patch expires on March 31.

Similarly, Congress's failure to reauthorize the current Medicaid primary care pay parity program- which pays primary care physicians and internal medicine and pediatric subspecialists no less than the Medicare rates for designated services to Medicaid enrollees-must not be the end of the story. Because Congress did not reauthorize this program, most physicians in the currently eligible specialties will see deep cuts in their Medicaid primary care payments on January 1. ACP will continue its efforts to inform the new 114h Congress of the devastating impact such cuts will have on Medicaid patients' access to primary care, and to seek to get the Medicaid pay parity program renewed early in the new Congress.

It is regrettable that the 113th Congress is adjourning without completing action on critically important legislation to reform Medicare physician payments and ensure that Medicaid patients will continue to have access to primary care physicians. The new 114th Congress can, and must, do better.

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 141,000 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.


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