Wednesday, March 5, 2014

Texas Physicians Call on Congress to Fix Medicare Formula Now

Physician leaders from the Texas Medical Association (TMA) are in Washington today to urge every member of the Texas congressional delegation to cosponsor landmark legislation that would strengthen Medicare by updating the program’s troubled payment system.

The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015/S. 2000) would transform Medicare into a 21st century program and repeal a fatally flawed formula for determining physician payments — known as the Sustainable Growth Rate (SGR). Two of the bill’s primary sponsors are U.S. Reps. Michael Burgess, MD (R-Lewisville), and Kevin Brady (R-The Woodlands). Congress has until March 31 to enact this bipartisan, bicameral legislation before the SGR formula mandates a drastic 24-percent cut to Medicare physician payments and threatens access to care for the state’s seniors and military families, and Texans with disabilities.

“Texas physicians and our patients can’t stand for any more short-term patches and repairs to this broken system,” said David Henkes, MD, a San Antonio physician and chair of the Texas Delegation to the American Medical Association. “My colleagues and I have come to Washington to impress this message on Sens. John Cornyn and Ted Cruz and all 34 Texans in the House of Representatives. We’ve all heard enough talk about repealing the SGR; it's time to act. And passing H.R. 4015/S. 2000 is the action we want.”

For Texas, the pending 24-percent cut would amount to $980 million for the balance of 2014 for the care of elderly patients and Texans with disabilities — an average of $18,000 per Texas physician. Cuts of this size would make it extremely difficult for physicians to pay for office space and other expenses and avoid staff layoffs. In Texas, access to care for 3.2 Medicare patients and 870,000 military family members, as well as the jobs of more than 265,000 employees of medical practices, are at risk due to these cuts.

Congress has long-debated the shortcomings of the SGR, resulting in a costly 11-year pattern of procrastination that has frustrated physicians, threatened patients’ access to care, and created a growing budgetary dilemma from which Congress has struggled to emerge. Over the years, Congress has spent more than $153 billion on 16 patches to the SGR formula, which is significantly more than the estimated 10-year cost of H.R. 4015/S. 2000.

TMA is working with Congress to move past this broken payment formula and toward a Medicare program that supports innovative payment models that would reduce costs while enhancing the delivery of high-quality, cost-effective care.

For more information, a link for the public to contact Congress, and an animated video explaining The Big, Bad SGR in terms even a child can understand, see the this post.

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