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Monday, November 18, 2013

SGR REPEAL BILL: IS IT GOOD ENOUGH?

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 Ray Callas. 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. The issue has generated a lot of debate at the AMA House of Delegates meeting that convened just outside Washington on Saturday. 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 another short-term congressional patch to avoid the 24-percent cut scheduled to take effect in January.

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