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ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
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Statement attributable to: David L. Bronson, MD,
FACP, President, American College of Physicians
January 2, 2013
Yesterday, the Senate and House passed bipartisan legislation
that will temporarily halt the 26.5 percent cut in Medicare
physician payments as a result of the flawed Sustainable Growth
Rate (SGR) formula. The legislation also includes provisions to
halt significant tax increases for the majority of Americans and
delays until March 1
across the board cuts (including a 2 percent cut to Medicare) -
which would result in billions of dollars in additional cuts - as
mandated by the Budget Control Act of 2011 through
Specifically, the American Taxpayer Relief Act of 2012 extends
the Medicare physician payments update at 2012 levels through 2013.
The legislation regrettably does not include any reforms to the
current SGR formula, nor does it provide any instructions on a
pathway to reforming the current payment system. The estimated cost
of delaying the SGR cuts for one year is $25 billion over 10 years
and is paid for mostly through cuts and adjustments to hospitals
and non-physician providers, including reductions to Medicaid
Disproportionate Share Hospital and Medicare Advantage Plan
payments. Some physicians may be adversely affected by a reduction
to the ESRD Bundled payment reflecting the decreased use of certain
medications included in the bundle, and a decrease in payments for
advanced imaging. Most of the reductions used to pay for the SGR
fix are based on recommendations previously made by the Medicare
Payment Advisory Commission (MedPAC) or the Government
Accountability Office (GAO).
It is notable that the legislation did not reduce or eliminate
the Medicaid Primary Care increase, also referred to as the
"Medicaid Parity" provision of the Affordable Care Act, which was
scheduled to be implemented on January 1. ACP played a key
leadership role in organizing a successful coalition effort,
supported by more than 250 national and state physician membership
to persuade Congress not to cancel the Medicaid primary care
increase in order to pay for stopping the Medicare SGR cut.
Although the final bill passed by Congress postpones the
Medicare SGR cut, preserves the Medicaid primary care increases,
and temporarily averts massive cuts in federal health programs that
would have had a devastating impact on patient care, it falls well
short of ACP's goals of enacting a permanent replacement to the
Medicare SRG formula and enacting a fiscally- and
socially-responsible alternative to across-the-board cuts.
In the short term, this legislation helps ensure access to
high-quality medical care for Medicare beneficiaries, and ensures
that physician payments under Medicare will not be cut through
2013. However, a greater bipartisan effort is still needed in the
coming year to approve legislation that permanently repeals once
and for all the flawed SGR formula, and transitions to payment
models that provide predictable annual updates to physicians
participating in Medicare, while being aligned with the provision
of high quality and efficient care. ACP recently submitted a proposal to Congress outlining a clear
and reasonable transition to permanent SGR reform.
ACP will continue to make it clear to Congress that a permanent
solution to the Medicare SGR is required, not another round of
temporary "patches" - like the one just passed by Congress. It will
also continue to urge Congress to address the scheduled
across-the-board cuts mandated by sequestration, which are only
delayed for two months by this legislation, so that important
healthcare programs remain viable.
The American College of Physicians is the
largest medical specialty organization and the second-largest
physician group in the United States. ACP members include 133,000
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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