Several physician groups voiced strong concerns to recommendations adopted by the Medicare Payment Advisory Commission (MedPAC) that would replace the sustainable growth rate formula (SGR) with a 10 year schedule of payment reductions and payment freezes for physicians. In addition, 98 physician groups sent a letter to the Joint Committee on Deficit Reduction, commonly known as the Super Committee, asking them to include tort reform in their proposals.
MedPAC adopted a recommendation that would result in automatic cuts in payments to most physician specialties for several years and freeze the reimbursement rate for other physicians. Specifically, the proposal would replace the sustainable growth rate formula with a ten year path of legislated fee schedule updates. Under this path, payments for primary physicians would be frozen for the ten years and payments for services provided by a specialist would be cut by 5.9 percent for three consecutive years and then be frozen. The recommendation would cost about $200 billion over 10 years. In addition MedPAC’s proposal would cut $235 million from other providers to help off-set the cost of their 10 year plan.
The American Medical Association (AMA) said in a statement from its President Peter W. Carmel, MD, that it strongly opposes MedPAC’s recommendation. The AMA noted that “offsetting part of the cost of repeal through drastic cuts and long-term freezes to physicians falls far short of what is needed to preserve patients’ access to care.” Dr. Carmel noted that the recommendation voted on today by MedPAC flies in the face of their previous recommendations to stop harmful physician cuts that threaten access to care for patients.
The American College of Cardiology (ACC) also issued a release strongly opposing MedPAC’s proposal. ACC CEO Jack Lewin stated, “the proposal is not an acceptable or sustainable solution to the SGR and does nothing to promote quality or resource stewardship.” He continued, “this proposal somewhat misaligns the interests of primary and specialty doctors, rather than focusing on incentives to work together to improve quality, efficiency, coordination of care, and outcomes.”
In addition to these physician groups the American Hospital Association (AHA) said in a letter to MedPAC that it felt that offsetting the cost of the SGR repeal with Medicare cuts to hospitals and other providers is merely robbing Peter to pay Paul and is the wrong approach. Hospitals employ more than 200,000 physicians. The AHA also supported tort reform as a way to save money.
Physician Letter to Joint Deficit Reduction Committee
The AMA and 98 other medical groups signed a letter urging the Joint Deficit Reduction Committee to include tort reform as part of its effort to cut at least $1.2 trillion from the nation’s deficit. In a statement, AMA President Peter W. Carmel said, “Reforming the costly and inefficient medical liability system with proven solutions will save taxpayers money.” The medical groups are seeking a firm cap of $250,000 on non-economic damages that can be assessed against physicians in malpractice suits.
Additionally, medical specialists requested that the Budget Deficit Committee repeal the Independent Payment Advisory Board (IPAB) created by the Patient Protection and Affordable Care Act (P.L. 111-148). The IPAB would recommend cuts to Medicare payments when growth in Medicare spending exceeds a certain percentage. The IPAB cuts would go into effect automatically unless Congress voted to stop their implementation.