Three societies unite, call for repeal of SGR at congressional briefing

The Society for General Internal Medicine organized with the American College of Physicians and the American Association of Family Physicians to call on Congress to repeal the Medicare physician’s sustainable growth rate that mandates cuts to reimbursements.

Members of the three groups attended a congressional briefing with about 45 staffers from the House and Senate on Sept. 30.

Stopgap measures have been put into place 17 times to avoid implementing the cuts, and Mark D. Schwartz, MD, professor of population health at New York University School of Medicine and chair of the health policy committee for SGIM, told Healio.com in an interview that the measure should be repealed during the current lame-duck session for several reasons.

One issue is that the current congressional session will be over at the end of the year, so the bill designed to replace the SGR currently under consideration would expire and have to be reintroduced.

Newly elected officials will replace some current members, and Schwartz said it will take time for those officials to be assigned to pertinent committees. The result is that initiating discussions with new members would not be feasible until at least the end of March, when the current freeze expires. At that time, the Congressional Budget Office also will rescore the data, and the costs of the measures likely will rise, Schwartz said.

Some congressional members who are exiting their offices have other motivations to pass the current bill, according to Schwartz.

“There are people leaving Congress who care a lot about this issue,” Schwartz said. “They want to have this as part of their legacy and feel that they were responsible for fixing this problem.”

The briefing was triggered by the reissue of a report along with an editorial in The Hill co-written by William “Bill” Frist, MD, a heart and lung transplant surgeon who served in the Senate from 1995 to 2007, including a term as majority leader from 2003 to 2007, and Steven Schroeder, MD, MACP, a distinguished professor of health and health care at the University of California, San Francisco. They chaired the National Commission on Physician Payment Reform and issued the original report, which made 12 recommendations on how physicians are reimbursed, including repealing the SGR, replacing it with a different model and tying payment to value.

Schwartz said the staffers seemed engaged and a lengthy discussion followed their presentation.

“I think it went great,” he said. “They were clearly interested in what we had to say. I think they were a bit surprised and struck by the fact that they have had three different physician groups having the same thing to say.”

While Schwartz is encouraged, the bill’s fate remains unclear.

“What is unprecedented is having bipartisan and bicameral agreement on what the policy should be,” Schwartz said. “In the bill that was introduced, there is something for everybody to dislike, but it gets the job done of repealing the current law creating these perpetual cuts that CMS would be compelled to make,” had temporary freezes not been established 17 times.

“I think there is clear agreement they want to fix it,” Schwartz said. “What they could not agree on was how to pay for it.” –by Shirley Pulawski

Disclosure: Schwartz works in academic medicine and reports no relevant financial disclosures.