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Letter describes two issues that must be considered during
lame-duck session to ensure high-quality, accessible and affordable
care for patients enrolled in Medicare and Medicaid
November 20, 2014
(Washington) - It is critical that Congress consider two issues
in this post-election lame-duck session The American College of
Physicians (ACP) today told Senators Reid and McConnell and
Representatives Boehner and Pelosi. A three-page
letter from David A. Fleming, MD, MA, MACP, president of ACP
emphasized the importance of enactment of the "SGR Repeal and
Medicare Provider Payment Modernization Act of 2014" (H.R. 4015/S.
2000), and continuation of the Medicaid Primary Care Pay Parity
program, which is set to expire on Jan. 1, 2015.
"It is time for this Congress to put an end to the endless
debate over the SGR and fix a broken physician payment system," Dr.
Fleming declared , "by enacting the 'SGR Repeal and Medicare
Provider Payment Modernization Act of 2014' in the lame-duck
Dr. Fleming also pointed out that "by repealing the SGR, this
legislation removes the single greatest roadblock to achieving real
payment reform. But it does much more than this: it creates
powerful incentives for physicians to adopt innovative payment and
delivery models, like Patient-Centered Medical Homes, to improve
the quality, accessibility, and cost-effectiveness of patient
This bill, which was the product of months of hearings,
consideration and debate, has been endorsed by more than 600
physician organizations, including ACP, by the chairs and ranking
members of the Senate Finance, House Ways and Means, and Energy and
Commerce Committees, by physician members of Congress, and by many
other patient, health care provider, and business advocacy
"Unlike past legislative years, Congress is at a juncture today
where it has finally achieved bipartisan, bicameral consensus on
legislation to achieve these essential goals," Dr. Fleming
"It is also critically important that Congress reauthorize what
is often referred to as the Medicaid Primary Care Pay Parity
Program, as proposed in the Ensuring Access to Primary Care for
Women & Children Act, H.R. 5723 and S. 2694," Dr. Fleming
noted. "The Medicaid Primary Care Pay Parity program ensures that
physicians practicing in designated primary care specialties and
related subspecialties continue to receive Medicare-level
reimbursement rates for providing primary care and immunization
services to patients enrolled in Medicaid. Well-established
research has shown that low Medicaid payment, which in many states
has historically been well below the costs of delivering care, has
been a major reason physicians are reluctant to participate in the
Finally, on the pay-parity issue, Dr. Fleming said, "Maintaining
access to primary care and related medical and pediatric
subspecialists, by ensuring comparable rates under Medicare and
Medicaid for these services, is especially critical at a time when
the population enrolled in Medicaid is surging. These comparable
Medicaid payments serve as incentives for eligible physicians to
maintain or increase their Medicaid patient population in all
states, whether or not a given state has elected to expand its
Medicaid program. A recent survey of a representative sample of ACP
members found that almost half of those participating in the
current Medicaid Primary Care Pay Parity Program would have to
reduce the number of Medicaid patients they see, or drop out of the
program altogether, if the program is allowed to expire at the end
of this year."
Dr. Fleming concluded the letter to Congressional leadership by
repeating ACP's asks:
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.
David Kinsman, (202) firstname.lastname@example.org
Jacquelyn Blaser, (202) email@example.com