VOLUME 26, ISSUE 1
How to Unload the Unsustainable Sgr?: MA and AMA Fighting for Our Patients and the House of Medicine
Article Reprinted and Modified with Permission from the TMA
TMA Board of Trustees Chair Carlos Cardenas, MD, led a group of Texas physician leaders, TMA Vice President of Advocacy Darren Whitehurst, and me — plus senior staff and key physicians from eight other state medical societies — in an intense, three-day lobby visit to Capitol Hill. We met with congressional health care leaders like Reps. Michael Burgess, MD (R-Lewisville), and Kevin Brady (R-The Woodlands) plus Republican and Democrat staff of the key committees of jurisdiction. We also enjoyed audiences with Reps. Xavier Becerra (D-Calif.), John Fleming, MD (R-La.), and Bill Cassidy, MD (R-La.). Dallas orthopedic surgeon John Gill, MD, and Rep. Pete Sessions (R-Dallas) also set up lawmaker-physician meetings that included Drs. Carolyn Evans, Asa Lockhart, Russ Kridel, and myself. The major topic of conversation was the joint proposal from the House Ways and Means Committee and Senate Finance Committee to repeal the Medicare Sustainable Growth Rate (SGR) formula that has bedeviled physicians’ Medicare payments for more than a decade. The draft plan does away with the SGR but imposes a 10-year freeze on physicians’ Medicare payments and establishes several new pay-for-performance programs. While several national specialty societies are supporting the bill as is, TMA, the American Medical Association, and the Coalition of State Medical Societies is pushing for substantial improvements and elimination of a host of onerous federal health care regulations. An influential health care blog published a commentary from the coalition that outlines our concerns.
In an increasingly rare show of unity on a difficult issue, the American Medical Association House of Delegates endorsed a strong plan to repeal the SGR by the end of 2013. The plan maintains support for AMA’s and TMA’s pay-for-performance principles and pushes to keep fee-for-service as an important Medicare payment model. Before approving the proposal, delegates insisted on adding language directing AMA to work for increases in the Medicare physician fee schedule. The agreement stems from what AMA President Ardis Hoven, MD, called “a new cause for optimism” on repealing the SGR in Congress and among physicians. A delegation of Texas physicians and medical students and TMA staff enjoyed productive conversations on the issue during visits with House members and Sen. Ted Cruz after the Washington meeting of the AMA House of Delegates. The Senate Finance Committee scheduled an Dec. 12th “open executive session” on a draft SGR repeal proposal that had support from Democrats and Republicans, and in both the House and the Senate. We suspect it will take at least several months for any final product to make its way through Congress — if that happens at all. That means we’ll need to continue advocating for repetitive patch jobs to avoid the seismic cuts with which we are all too familiar.
Other Advocacy Issues Dominate AMA Meeting
Protecting physician practices from the ravages of the 90-day grace period in the Affordable Care Act (ACA) marketplace plans, scope of practice, and license recertification were the hot topics in the opening days of the AMA House of Delegates meeting. As usual, members of the Texas delegation
AMA HOD Unified Push for SGR Repeal
Replacing the Medicare SGR formula was also front and center at the AMA House of Delegates meeting that convened outside Washington D.C. in November.
