TMA EVPGram

As usual, it takes a deadline with a big cut in physicians’ Medicare payments for Congress to act. This time, it’s the 10.6-percent cut scheduled for July 1. TMA is very engaged in the debate, and we’re working with all of our allies in Washington to stop the cut and find a way to stop this annual circus. A TMA team of physicians and county society executives will be in Washington June 23 for our annual Border Health Conference. It’s a highly charged and partisan atmosphere, but there is some movement in our direction. And thanks to Texas physicians’ hard work, most of the Texas congressional delegation supports a bigger Band-Aid than we’ve seen in recent years, and they want a permanent Medicare fix. Here’s where we are so far:

• The most recent plan we’ve seen from Senate Finance Committee Chair Max Baucus (D-Montana) would stop the cut and institute a 1.1-percent increase for the rest of this year and all of 2009.
• That would give Congress 18 months to devise a long-term replacement for the sustainable growth rate (SGR) financing formula. It also sets up a very steep cliffhanger: The cost of the 18-month delay would require a cut in physician Medicare payments of 20 percent or more in 2010.
• That cut is even more incentive to replace the SGR with a system that keeps up with the cost of running a practice. The best permanent fix bills have come from Texans: Sen. John Cornyn and Rep. Michael Burgess, MD (R-Lewisville).
• Financing the 18-month stopgap also includes money set aside to increase payments to Medicare Advantage plans. President Bush has threatened to veto any bill that cuts on Medicare Advantage.