June 2005 | Vol. 23, No. 6

Medicare Physicians Could Receive a Payment Increase in 2006, Says CQ HealthBeat News

According to an article by Mary Agnes Carey in the May 20 edition of CQ HealthBeat News, a new Federal health care policy e-mail newsletter from the Congressional Quarterly, a bill in Congress introduced by Senator Jon Kyl (R-AZ), and now co-sponsored by 6 other Senators, could result in Medicare physicians receiving payment increases, instead of planned payment cuts, over the next two years. The Preserving Patient Access to Physicians Act (S. 1081) would provide a 2.7 percent payment increase in 2006 and a likely 2.6 hike in 2007. The measure would also scrap the sustainable growth rate formula, or SGR, that is now used to calculate Medicare physician payments.

S. 1081 follows a House bill of the same name (H.R. 2356) introduced recently by Rep. E. Clay Shaw, Jr. (R-FL), and now co-sponsored by 23 Representatives, that also would give physicians at least a 2.7 percent payment increase in 2006 and replace the SGR.

According to CQ HealthBeat News, “Medicare payments to physicians are scheduled to decline by 5 percent in 2006 unless Congress takes action to stop the cuts. An April AMA survey found that 38 percent of physicians said would reduce the number of Medicare patients they will accept if the cuts proceed as scheduled.”

“While Congress may take action to avert scheduled Medicare payment cuts to physicians next year, lawmakers and lobbyists have said it is unlikely that Congress will tackle a broader overhaul this year of the way Medicare pays physicians because it would be too expensive to do so,” says CQ HealthBeat News.

According to CQ HealthBeat News, “While there is a debate about whether or not the Centers for Medicare and Medicaid Services (CMS) has the authority to alter the SGR, ‘the fact of the matter is that without Congress stepping in to provide for a physician payment update, it probably will not occur,’ ” Kyl said.

Sen. Debbie Stabenow (D-MI), a co-sponsor of S. 1081, said Congress must act to fend off scheduled Medicare physician payment cuts that will total 22 percent over the next five years and $126 billion over 10. Without congressional action, Stabenow said, physicians may be “forced to limit the number of Medicare patients they serve,” reported CQ HealthBeat News.

“Doing nothing to solve this problem may cost us more: more money, more health and access problems, and more physicians leaving the profession,” Kyl said. “Although this legislation provides for a two-year update, we must develop a long range mechanism to pay physicians appropriately,” the e-mail newsletter said.

SVU will continue to monitor the progress of both S. 1081 and H.R. 2536 in the 109th Congress. SVU members also may want to contact their two Senators and sole Representative about becoming a co-sponsor of this important legislation. You can get your Representative’s or Senator’s office fax numbers by calling the U.S. Capitol Switchboard at 202-224-3121 and asking to be connected to your Representative’s or Senator’s office, and then tell them you are a constituent and would like the office fax number to fax a letter to the Representative or Senator about being a co-sponsor of the Preserving Patient Access to Physicians Act (H.R. 2356 / S. 1081). If you send a fax to your Members of Congress on this Bill, SVU would appreciate receiving a copy of your correspondence. Please send it to SVU Executive Director Steve Haracznak by email at steveh@svunet.org, by fax at 301-459-5651, or by land mail to the SVU national office in Lanham, MD.