Opposing the Protecting Access to Medicare Act

Dear Dr. Kothari,

On March 31, Congress passed the one year, short term patch to the Medicare sustainable growth rate (SGR) formula avoiding a 24.1 percent physician payment cut scheduled to take effect April 1 (the patch ends on March 31, 2015). The Protecting Access to Medicare Act (H.R. 4302) was opposed by the American College of Surgeons(ACS), which has never supported short term patches, and most national surgical and physician organizations.

We felt it necessary to actively oppose this bill because physicians will be made to cover some of the cost of the patch for the first time. The legislation requires CMS to address misvalued physician service codes between 2017 and 2020 and produce approximately $4 billion in savings, which is about 25 percent of the cost of the short term patch. Unfortunately, political maneuverings by the House and Senate leadership led to its passage despite significant opposition within the House and Senate rank and file membership.

Congress has now spent nearly $170 billion dollars in seventeen short-term patches over the last decade, a price tag well above the current cost to permanently repeal the SGR.

ACS will continue to advocate for passage of The SGR Repeal and Medicare Payment Modernization Act, H.R. 4015/S. 2000 (SGR Repeal Act), a bill that would benefit America’s seniors, and offers a long-term solution to stabilizing the SGR, this year. On the evening the patch was enacted, Rep. Michael Burgess, MD, (R-TX), the lead sponsor of H.R. 4015, and Vice-Chairman of the Energy and Commerce Subcommittee on Health, addressed the ACS Leadership & Advocacy Summit attendees and vowed continued efforts to pass the SGR Repeal Act. He stated, “this is not the end of my efforts.
I will continue to work on this issue. We are farther than we’ve ever been toward repealing and replacing the SGR.” In addition, Senate Finance Committee Chairman Ron Wyden (D-OR) stated that he will continue his efforts to pass permanent SGR repeal this year.

As part of the short term patch, Congress also voted to delay by one year the implementation of the nationwide conversion to the 10th Revision of the International Classification of Diseases (ICD-10) set of diagnostic and procedural codes until October 1, 2015. Also delayed was the enforcement of the Medicare two-midnight rule payment policy for hospitals until March 31, 2015.

We remain determined to permanently repeal the SGR this year and will not back down despite congressional action on a short term patch. We thank you for your efforts in this fight and will keep you apprised of any significant developments.