All Updates

The Patients’ Action Network is proud to support the AMA’s recently launched grassroots campaign urging Congress to repeal Medicare’s flawed sustainable growth rate (SGR) formula and transform Medicare into a 21st century model of care for patients. The centerpiece of this grassroots campaign is the website FixMedicareNow.org, which brings together patients, physicians and policymakers to find a long-term solution to the SGR.

Please visit FixMedicareNow.org and send an email to your representative and senators or place a phone call today via the toll-free grassroots hotline at (888) 434-6200. Encourage your lawmakers to continue working in a bipartisan manner and protect Medicare and seniors’ choice of physician by repealing the flawed Medicare SGR formula in 2013.

For a healthier tomorrow, let’s Fix Medicare Now!

AMA President Arden Dee Hoven, MD blogged about Congress’ recent work toward Medicare SGR repeal and improving patient care.

“Something remarkable happened last week. An important committee of the U.S. House of Representatives approved a bill to repeal Medicare’s failed sustainable growth rate (SGR) formula in a unanimous vote just before Congress left the capital for its summer recess.”

“Members of Congress have been working toward repeal of the SGR formula since the beginning of the year when Rep. Fred Upton, R-Mich., chairman of the U.S. House Energy and Commerce Committee, announced at the AMA’s National Advocacy Conference in February that his committee would introduce legislation to eliminate the SGR formula before the five-week summer recess.”

Read Dr. Hoven’s blog post.

After years of AMA advocacy, the nation’s leaders are working on plans to eliminate the sustainable growth rate (SGR) formula and revitalize the Medicare program for patients and physicians.

“The time is ripe for eliminating Medicare’s failed payment formula,” states AMA president Jeremy A. Lazarus, MD. “And the AMA will not rest until a new payment system is put in its place to promote the sustainability of physician practices and enable the highest quality care for all patients.”

Read Dr. Lazarus’ blog post.

There are a total of 20 physician members of the 113th Congress including three senators, 16 representatives and a delegate. Learn more about the physician members of Congress by connecting with them on Facebook, Twitter and YouTube.

House of Representatives

Rep. Dan Benishek, MD (R-MI-01)
General Surgery


Rep. Ami Bera, MD (D-CA-07)
General Practice


Rep. Charles Boustany, MD (R-LA-03)
Cardio-Thoracic Surgery


Rep. Paul Broun, MD (R-GA-10)
Family Medicine


Rep. Larry Bucshon, MD (R-IN-08)
Thoracic Surgery


Rep. Michael Burgess, MD (R-TX-26)
OB/GYN


Rep. Bill Cassidy, MD (R-LA-06)
Gastroenterology


Del. Donna Christensen, MD (D-VI-AL)
Emergency Medicine


Rep. Scott DesJarlais, MD (R-TN-04)
Family Medicine


Rep. John Fleming, MD (R-LA-04)
Family Medicine


Rep. Phil Gingrey, MD (R-GA-11)
OB/GYN


Rep. Andy Harris, MD (R-MD-01)
Anesthesiology


Rep. Joe Heck, DO (R-NV-03)
Emergency Medicine


Rep. Jim McDermott, MD (D-WA-07)
Psychiatry


Rep. Tom Price, MD (R-GA-06)
Orthopedic Surgery


Rep. David “Phil” Roe, MD (R-TN-01)
OB/GYN


Rep. Raul Ruiz, MD (D-CA-36)
Emergency Medicine


Senate

Sen. John Barrasso, MD (R-WY)
Orthopedic Surgery


Sen. Tom Coburn, MD (R-OK)
Family Medicine


Sen. Rand Paul, MD (R-KY)
Ophthalmology


On Jan. 1, Congress reached a last-minute deal to avert a 26.5 percent Medicare payment cut which would have severely hurt access to care for Medicare beneficiaries. Current Medicare payment rates have been extended through Dec. 31, 2013.

Read a summary of the Medicare and other health provisions.

While Congress was able to delay drastic cuts for one year, their work is not complete. The current structure of the Medicare program is increasingly unreliable for physicians and patients. The routine delays, last-minute actions and “kick the can” approach by Congress only reinforces the need for change and long-term reforms in the Medicare program.

The newly elected members of the 113th Congress will take office this week and have the opportunity to work in moving Medicare towards a more reliable and stable system that preserves patients’ access to care. Pressure must remain on lawmakers to permanently repeal the sustain growth rate (SGR) formula and enable common sense, sustainable Medicare reforms in 2013.

The Patients’ Action Network will continue to provide the latest information on the path to repeal of the SGR and reforming Medicare. Stay tuned for new action alerts and ways to remain engaged with your lawmakers. Thank you for your phone calls and emails to Congress on behalf of patients and preserving access to care.

Congress’ lame-duck session is forcing lawmakers to make important decisions affecting the future of medicine before a new Congress convenes in 2013.

Tough decisions will have to be made, but the AMA’s position is clear: Lawmakers on both sides of the aisle must make stopping a 26.5 percent cut to Medicare physician payments, driven by the flawed sustainable growth rate (SGR) formula and scheduled for Jan. 1, a top priority. They also must put in place a transition to a higher-performing Medicare program, beginning with permanent repeal of the SGR.

You can help. Contact your members of Congress through the Patients’ Action Network website or by using the the grassroots hotline: (888) 434-6200.

Urgent issues on the table revolve around the so-called “fiscal cliff,” which threatens a number of drastic tax and spending policy changes, including:

  • Across-the-board spending cuts under the Budget Control Act of 2011. Required to total $109 billion per year, these cuts affect both defense spending and domestic programs, including a 2 percent cut to Medicare physician payments.
  • Expiration of the Bush 2001 and 2003 tax cuts. The tax cuts include individual rates, capital gains, dividends, child tax credit expansion, marriage penalty reduction and the estate tax.
  • a patch to the alternative minimum tax. If left unchanged, 28 million Americans would face a hefty additional tax liability.
  • Expiration of the 2 percent payroll tax cut.
  • Medicare physician payment cuts of 26.5 percent, which are called for under the sustainable growth rate (SGR) formula.
  • Miscellaneous business tax provisions (also referred to as “tax extenders”).
  • Unemployment benefit extension.
  • Affordable Care Act tax provisions.

A critical piece of this is putting a stop to the Medicare physician payment reductions—totaling nearly 30 percent between the Budget Control Act and SGR cuts—that threaten physicians and their patients. Comprehensive reform of the Medicare physician payment system is sorely needed. And physicians are ready to lead the way toward a new and innovative models that will stabilize the Medicare program and promote high-quality, high-value care.

But first, Congress must act responsibly and stop the scheduled Medicare SGR cuts before it’s too late.

Last week Congress passed a 10-month patch to the flawed sustainable growth rate (SGR) formula stopping a potentially devastating 27 percent cut in Medicare payments to physicians on March 1 that would have negatively impacted seniors’ access to care and choice of physician. This agreement was part of a larger legislative package tied to the extension of the payroll tax cut and unemployment benefits.

This latest agreement is the 14th short term patch to the SGR in the last 10 years. The Patients’ Action Network will continue to urge Congress to once and for all repeal the SGR and stop this terrible cycle that continually threatens seniors access to critical care.

AMA President Peter W. Carmel, MD, issued the following statement:

“The House and Senate conference committee agreement averts a 27 percent cut on March 1, but it represents a serious missed opportunity to permanently replace the flawed Medicare physician payment formula and protect access to care for military families and seniors. People outside of Washington question the logic of spending nearly $20 billion to postpone one cut for a higher cut next year, while increasing the cost of a permanent solution by about another $25 billion.

“Congress had an opportunity to permanently end this problem, which is the sound, fiscally prudent policy choice. We appreciate efforts by members of Congress on both sides of the aisle who publicly supported a framework for a permanent end to this perennial problem. We are deeply disappointed that Congress chose to just do another patch — kicking the can, growing the problem and missing a clear opportunity to protect access to care for patients. Shortly after the coming elections, access to care for seniors and military will again be threatened by an even larger cut, and members of Congress will need to take swift action to end the broken formula.”

Now more than ever, it is critical for grassroots America to remain engaged on this incredibly important issue. Your active participation in calling and emailing your representatives and senators over the last several months and urging Congress to repeal the SGR is helping to build political momentum. With your continued support, we will repeal the flawed SGR and protect patient’s access to care and choice of physician.

Stay tuned for future “calls to action” and legislative alerts.

Seniors may lose their choice of physician on March 1st and physicians will face a 27.4% cut if Congress does not act to protect Medicare. Watch our new ad below and then take action! Tell your Representative and Senators that growing the problem is not the solution – stop the Medicare payment cuts! Email them and then call them using the Patients’ Action Network hotline at (888) 434-6200.

This month a House-Senate Conference committee will begin meeting as early as January 17th to resolve outstanding issues on pay roll taxes, unemployment insurance, and Medicare’s flawed SGR forumla.

There continues to be bipartisan interest in taking this opportunity to repeal the SGR, utilizing in whole or in part the excessive funds included in the current baseline for Overseas Contingency Operations, or OCO.

It is critical that we encourage the efforts of those in the House and Senate who support repeal of the SGR and who recognize that continued temporary patches drive the costs of eventual repeal higher by tens of billions of dollars every time it is delayed.

Learn more about why we need to fix the flawed SGR formula:
Now is the time to fix SGR
Implications of a one-year Medicare patch
Implications of a two-year Medicare patch

The U.S. House of Representatives on Tuesday rejected a Senate bill that would have averted a 27.4 percent Medicare physician payment cut scheduled for Jan. 1, leaving 2012 Medicare payment rates in limbo. A House-Senate conference committee will now be charged with working out differences between the two versions of the bill.

With both the House and Senate adjourning for the holidays, it does not appear likely that the outstanding issues will be resolved before Jan. 1. The House is scheduled to return to Washington on Jan. 17, while the Senate is scheduled to return on Jan. 23. However, there are reports that the House may move the date of its return up to Jan. 3.

The Centers for Medicare & Medicaid Services announced that it would hold claims for 2012 physician services for 10 business days—until Jan. 17—to avoid processing payments at the lower rate. After that date, claims will be processed on a first-in, first-paid basis at the reduced rates until the situation is resolved.

The AMA reaffirms its opposition to any short-term patches to the SGR formula, denouncing the political brinkmanship that left the issue unresolved until Congress was adjourning, and calling for a bipartisan effort to repeal the flawed and disruptive formula once and for all.

“It is long past time for members of Congress to act decisively and protect access to care for seniors and military families,” AMA President Peter W. Carmel, MD, said in a statement.

Stay tuned for further updates and ways to get involved.

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