Capitol Hill Report: Permanent Physician Payment Fix Passes House -- Will It Really Happen?

A Permanent Physician Payment Fix

November 23, 2009


By Mike Amery, Legislative Counsel, Federal Affairs, (202) 349-4299,

The mission of the Academy is to be "indispensable to its members." One way the Academy fulfills this mission is by representing of neurology in the halls of Congress. Capitol Hill Report presents regular updates on legislative action and how the AAN ensures that the voice of neurology is heard on Capitol Hill. The Academy's legislative counsel in Washington, DC, Mike Amery, offers weekly updates on advocacy for neurology and neurologic concerns.

Last week the US House passed HR 3961, which repeals the sustainable growth rate (SGR) formula and provides a positive update for 2010 instead of a 21 percent Medicare physician payment cut. It also eliminates all SGR debt accumulated over the years because of temporary, unfunded fixes. The Academy thanks the more than 700 members who contacted their members of Congress to ask for support of this bill. The bill passed 243 to 183 on a mostly party line vote. Eleven Democrats voted against it, but one Republican, Michael Burgess, MD, from Texas voted in favor. Burgess is rapidly becoming known in Congress for his support of physicians.

Will It Make a Difference?

Just two weeks ago, the Senate failed to move forward on a similar bill. I met with House Republican Minority Leader John Boehner (R-OH) on the night before the vote and urged him to support the permanent repeal of the SGR. Unfortunately, he said that the bill was "unpaid for, fiscally irresponsible, and had absolutely no chance of passing because of the position of the U.S. Senate." Earlier in the day, I had met with Sen. Barbara Mikulski (D-MD) and asked if she thought it might change some votes if the House passed a permanent repeal. She indicated that it is still a tough situation but that House passage might make a difference.

The issue now goes back to the Senate, where Majority Leader Harry Reid (D-NV) has said he will reintroduce the bill once the Senate completes health reform legislation. The Academy will press the Senate to act along with many other physician specialties.

The Primary Care Bonus

On Saturday night, the Senate voted 60 to 39 to move forward with the debate on health care reform. Along with concern over the pending cut in Medicare due to the SGR, the Academy remains focused on ensuring that neurology is included in any primary care incentive program. Congresswoman Betty McCollum (D-MN) introduced an amendment to add neurology to the House bill, but House leadership allowed only two amendments to be considered on the floor of the House. Our opportunities are much greater in the Senate. Sen. Amy Klobuchar (D-MN) has agreed to offer the amendment, and we are currently seeking cosponsors for the amendment. We are also collecting letters of support from patient groups, some of which can be viewed here.

The debate on amendments to the Senate health bill will begin after the Thanksgiving break. Senate Democrats hope to have reform passed by Christmas. The reality is that the bill still has a number of very controversial provisions that are sure to keep health reform on front pages for some time. Watch out for Academy action alerts to help us raise the voice of neurology on health care reform in the halls of Congress.

Read all of Mike Amery's reports on the Capitol Hill Report page.