Alliance of Specialty Medicine calls for permanent fix to Medicare SGR formula

Dec 1 2010

In response to Congress acting to postpone unprecedented reimbursement cuts to doctors who treat Medicare patients, The Alliance of Specialty Medicine (Alliance) today called on lawmakers to work towards a permanent solution to fix to the program's Sustainable Growth Rate (SGR) formula so temporary fixes would no longer be necessary.

“We hope that come January, Congress will remember its commitment to providing quality health care to seniors who have Medicare. This would mean finally replacing the flawed payment formula with a new system that recognizes the true cost of providing health care in America”

"We appreciate Congress' decision to protect seniors' medical care by further delaying the draconian Medicare reimbursement cuts set to occur, but the nation needs Congress to permanently fix the Medicare reimbursement formula to ensure senior citizens have access to the medical care they need, when they need it," said Dr. Alex B. Valadka, a neurosurgeon from Austin, TX and spokesperson for the Alliance. "Medicare reimbursement hasn't kept up with the promising medical discoveries and treatments that science has created, so a new system that takes into account these life-saving advances must be established. Our greatest generation deserves our best medical care."

The SGR is Medicare's current formula for determining annual updates to physician payments for services. The current temporary fix to this formula, which ends November 30^th, would have mandated reimbursement reductions of 23% for physicians who see Medicare patients. This latest temporary fix will continue the existing 2.2 percent update through 2010. Physicians will then be faced with a 24.9% reduction on January 1, 2011 without further intervention.

While there is discussion among Congressional leaders to follow up on today's action with a one-year SGR fix, Dr. Valadka called on Congress to make permanent changes to the SGR formula, emphasizing its importance to the Medicare system's stability.

"We hope that come January, Congress will remember its commitment to providing quality health care to seniors who have Medicare. This would mean finally replacing the flawed payment formula with a new system that recognizes the true cost of providing health care in America," said Dr. Valadka. "Providing a permanent fix to this outdated formula would stabilize the system and help ensure Medicare patients continue to receive the best quality medical care possible."

The Alliance of Specialty Medicine actively engaged in policy discussions during the health care reform debate and continues to work with Members of Congress to develop sound public policies that strengthen our nation's health care delivery system.