AAO opposes cuts in Senate Finance Committee health care reform bill

Taking issue with certain Medicare provisions, the American Academy of Ophthalmology and other medical groups have registered opposition to the health care reform bill the U.S. Senate Finance Committee passed Tuesday.

"The Academy has taken its gloves off in the health care reform debate to oppose the Senate Finance Committee bill as passed out of committee," Catherine Cohen, AAO vice president for governmental affairs, told Ocular Surgery News. "We continue to work with Senate and House champions to eliminate the problematic provisions as the bills are merged. We must have a bill that expands coverage and maintains a pluralistic health care system that provides choices for patients and their physicians."

The main sticking points are potential cuts in Medicare physician payments and penalties for some participating physicians, according to an AAO press release. The American Medical Association and American College of Surgeons joined forces with the AAO to push for revisions to the bill, the release said.

The AAO said the bill lacks a long-term alternative to the sustainable growth rate, a factor in the Medicare payment formula. The bill includes a 1-year SGR fix that would result in a 25% reduction in physician payments in 2011, according to the release.

"Even though Congress is highly unlikely to let such a cut go into effect during an election year, medicine has argued that you cannot take steps to reform the Medicare program without a permanent, stabilizing fix for physician pay," the release said.

The AAO also opposed a provision in the bill calling for the expansion of health insurance coverage to be funded through cuts in Medicare. Additionally, the Finance Committee would create an independent Medicare advisory commission. Hospitals would be exempt from consideration for payment cuts made by the commission, forcing physicians to bear $12 billion in cost savings accrued over 5 years, the release said.

The bill also called for the calculation of physician payments based on a value index, a 5% cut for physicians in the top 10th percentile of resource-use outliers, penalties for non-participation in the Medicare Physician Quality Reporting Initiative starting in 2011, bonuses for primary care funded by cuts to other specialties, and a $350 enrollment fee for physicians who wish to participate in Medicare and Medicaid.