AADA responds to House Ways and Means, Energy and Commerce inquiry about SGR
In response to a request for comment, the AADA sent recommendations to the House Ways and Means Committee and the Energy and Commerce Committee regarding a second draft of their recent proposal to repeal the sustainable growth rate (SGR) formula, and eliminate the estimated 24.4 percent across-the-board Medicare rate cut scheduled to go into effect on Jan. 1, 2014.
The AADA expressed concern about the establishment of expert panels – to provide guidance on the implementation of physician and non-physician incentive programs – which may not require physician members. The AADA reiterated its position that when determining policy that affects the physician community, it should be physicians themselves and the relevant specialties that should be consulted as the experts in the care they provide.
The AADA stressed the need to maintain Fee-For-Service (FFS) as an option for physician practices and specialties that do not necessarily fit into various alternative payment models. Read the AADA's proposal letter and answers to the Committees' specific questions on SGR reform.
Congress agrees to one-year reprieve from Medicare payment cuts
Congress agreed to a one-year reprieve from the 26.5 percent physician Medicare payment cut that was scheduled to begin Jan. 1, 2013, due to the flawed sustainable growth rate (SGR) formula as a part of a larger package to avert what has come to be known as the "fiscal cliff."
Additionally, Congress agreed to defer the 2 percent across-the-board cuts to government programs, including Medicare, for two months. Through this process, known as sequestration, on March 1, 2013, Congress and the White House failed to avert a 2 percent cut in Medicare payments.
Congress agreed to fix another component of the formula intended to reflect geographic differences in the costs of resources needed to produce physician services. However, Congress did not make any changes to the practice expense and work relative values that were previously contained in the 2013 Medicare physician fee schedule.
The American Academy of Dermatology Association (AADA) President Daniel M. Siegel, MD, reiterated the organization’s commitment to finding a permanent solution to the SGR formula issue, and urged Congress to immediately address this problem by enacting a long-term solution.
Physicians have repeatedly argued that the constant instability in the Medicare physician payment structure threatens patient access to quality medical care. The AADA will continue to push for reform to Medicare’s physician payment system to create a stable one that protects Medicare’s patients, pays physicians fairly, and improves quality and efficiency.
Learn more about how this congressional action and the 2013 CMS Medicare physician fee schedule changes will affect your practice in 2013.
Federal budget office releases report detailing sequestration cuts
The Office of Management and Budget (OMB) released a report detailing the sequestration cuts triggered by Congress's failure to enact a plan to reduce the deficit by $1.2 trillion. The report provides an explanation of which programs would be cut, the extent of the cuts, and which programs would be exempt from cuts.
According to the report, roughly $109 billion in cuts would be implemented every year from fiscal year 2013 to fiscal year 2021. Specifically, Medicare's 2 percent cut will come out of provider payments rather than enrollee benefits. Additionally, medical research funding will be negatively affected by the looming sequestration cuts, with the Centers for Disease Control and Prevention facing about $464 million in cuts to discretionary programs and the National Institutes of Health facing about $2.5 billion in cuts. The AADA is urging Congress to enact legislation to stop the physician payment cuts and restore medical research funding.
AADA supports bill strengthening Medicare patients’ access to care
In April 2013, the AADA signed on to a coalition letter supporting legislation that would allow Medicare patients to access the physician of their choice, even if the physician is no longer accepting Medicare. Introduced by Rep. Tom Price, MD, (R-Ga.), HR 1310, the Medicare Patient Empowerment Act would ensure that Medicare beneficiaries and physicians are able to freely contract for covered Medicare services without penalty, while at the same time providing important beneficiary protections.
Under current law, Medicare beneficiaries that choose to see physicians who do not accept Medicare are required to pay the physician's charge entirely out of pocket as Medicare does not pay any part of the charge. In addition, physicians who choose to provide covered services to Medicare beneficiaries under private contracts must "opt out" of the Medicare program for two years, during which time Medicare does not pay the physician for any covered services provided to Medicare beneficiaries.
If enacted, HR 1310 would significantly strengthen Medicare patients’ access to care. Read the AADA letter of support.