Capitol Hill Report: Congress Delivers Early Thanksgiving Turkey

June 21, 2010

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By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506-7468, mamery@aan.com

Medicare Physician Reimbursement Cuts
The U.S. Senate has again resorted to a short-term fix of the Sustainable Growth Rate (SGR) problem that currently calls for a 21 percent cut in physician reimbursement under Medicare. Assuming it is passed by the House, which is not a done deal according to a press release issued by House Speaker Nancy Pelosi (D-CA) , Congress will prevent cuts for just six months leaving physicians looking for a pardon around Thanksgiving, just like the ceremonial White House turkey.

Of course, this time the cut actually went into effect as last Friday the Centers for Medicare and Medicaid Services (CMS) began implementation. The Senate legislation provides for retroactive payments back to June 1, but some Medicare claims have been processed at the lower rate and some will require reprocessing. All of this burdens physician practices and provides less confidence in the long-term sustainability of the Medicare program.

Why Isn't This Done?
I talked to several members of Congress last week about the Academy's position that Congress needs to find a permanent fix for the SGR. I met with key members of both sides of the aisle including Senate Minority Leader Mitch McConnell (R-KY), House Ways and Means Chairman Sander Levin (D-MI), and a true supporter of physicians, Rep. Mark Kirk (R-IL), who is running for the U.S. Senate in Illinois.

Hopefully candidates who support neurologists like Kirk will get elected and we will have enough supporters to permanently fix this ridiculous situation. But as it stands now everyone says they want to do something, that this isn't a partisan issue, and that it just comes down to cost.

The thing that gets me is that everything Congress passed in 2009 seemed to add to the deficit!  Now the brakes are on when it comes time to ensure that Medicare beneficiaries have adequate access to care?

I'm not arguing that we should increase deficits, but I have trouble comprehending how Congress can bail out banks and automobile manufacturers, yet continue to ignore fixing a problem they created themselves and continue to say ‘not this time’ to the nation’s seniors.

Patient Support – You Can Help

Although the Academy hopes that Congress prevents the cuts, it continues to call for a permanent repeal of the unsustainable SGR. We are urging physicians to ask their patients to raise their voices with ours and sign the Medicare Petition, which can be found by clicking here. If you wish, you can also print material to share with your patients.

Patient Advocacy Groups

Patient advocacy groups are becoming more concerned about congressional policies that affect physicians. Last week, Parkinson's Action Network hosted a meeting that was attended by the Academy as well as the National MS Society , Epilepsy Foundation , Alzheimer's Association , Brain Injury Association of America , and ALS Association to talk about issues impacting neurologists and patients.

These same patient groups were the strongest supporters of the Academy's effort to include neurology in efforts to incentivize cognitive care in the health care reform bill. One of the results of the meeting was an agreement to draft a letter of support for including neurology in any technical corrections to health care reform.

Some of the patient groups also agreed to start lobbying on Capitol Hill with me on this issue. In fact, the Epilepsy Foundation will join me for meetings with the office of Congresswoman Allyson Schwartz (D-PA) and with Congressman John Dingell (D-MI) , the former chair of the House Energy and Commerce Committee, who has expressed an interest in ensuring that neurology is included in any technical corrections bill regarding health care reform. For more information on the history of this issue, please review my Capitol Hill Report from April 2, 2010