AAO backs bipartisan bill to repeal SGR, avert 24% Medicare payment cut

The American Academy of Ophthalmology expressed support for bipartisan, bicameral federal legislation that would repeal the sustainable growth rate, a key factor in annual Medicare physician payment updates.

Perspective from Michael X. Repka, MD

Physicians face a 24% payment cut on April 1 unless Congress intervenes, according to an AAO news release.

Congress has averted several physician payment cuts stemming from the SGR over the last decade.

H.R. 4015/S. 2000, the SGR Repeal and Medicare Modernization Act of 2014, was introduced and referred to House committees on Feb. 6.

“This legislation represents a major milestone in physicians’ nearly 10-year battle to repeal the flawed sustainable growth rate formula used to calculate Medicare reimbursement,” David W. Parke II, MD, CEO of the AAO, said in the release. “The Academy applauds the efforts of the members of the Senate Committee on Finance, the House Committee on Ways and Means, and the House Committee on Energy and Commerce for their efforts in developing this bipartisan legislation. Ophthalmology joins our colleagues across medicine in strongly urging lawmakers to pass this legislation in order to protect the viability of physicians’ practices and ensure beneficiaries have access to the highest quality medical and surgical care available.”

The AAO, the American Medical Association and other advocacy organizations have urged Congress to alter or repeal the SGR.

Perspective

Michael X. Repka, MD

Repeal of SGR has been one of our important advocacy initiatives and this bill does that. We did also appreciate the positive update for 5 years although we certainly preferred the positive update guarantee for 10 years that was in earlier versions of the bill. There are important issues that we still have with the proposal. Streamlining the quality and value-based purchasing programs is good, but the replacement, the Merit-Based Incentive Payment System, or MIPS, is not necessarily better.

We have been communicating that concern to members and their staff, and asking that the program needs to allow ophthalmologists to successfully participate in this program as well as future alternative payment models which will provide bonuses to participating physicians.

The other important concern is the section on mis-valued procedures. Will this lead to an unfair reduction in the value of procedures?

In sum, we think it's important to get beyond SGR so that physician payment is not a continuing source of uncertainty each year as well as modify some of the existing problems in physician payment.

Michael X. Repka, MD

Medical director for governmental affairs, American Academy of Ophthalmology

Disclosures: Repka is a salaried consultant for the American Academy of Ophthalmology.