Another lost opportunity


Congress came closer than ever to fixing the fatally flawed Medicare Sustain- able Growth Rate (SGR) formula used to calculate physician fees every year. The stars appeared to align when both parties and both chambers of Con-


gress actually agreed on a bill to once and for all eliminate the SGR problem that for the past decade threatened steep cuts to physician payments and to transition to a new quality reporting-based system. The Congressional Budget Office (CBO) slashed the price tag on repealing the SGR to $138 billion over 10 years — just over half the $244 billion it would have cost in 2012. Extensive lob- bying efforts by the Texas Medical Association, the American Medical Associa- tion, and organized medicine overall finally seemed to pay off. “All of the legislators I talked to on the Hill were in enthusiastic agreement


that we have to get this fixed now,” said Dawn Buckingham, MD, pictured at left, chair of TMA’s Council on Legislation. The reform legislation had a fatal flaw of its own, however: “The big conflict was over how to pay for it.” Congress let physicians down before, she says. But this time, the unprec- edented progress made lawmakers’ familiar political routines particularly vex- ing when — for the 17th time — they defaulted to a temporary patch. On March 31 — the eve of a scheduled 24-percent pay reduction — Congress put another Band-Aid on the problem by legislating a 12-month freeze on current payment rates until April 1, 2015. In another measure of relief, the legislation delayed the ICD-10 start date for one year, to Oct. 1, 2015. (Read “ICD-10 Countdown Contin- ued,” May 2014 Texas Medicine, pages 22–29.)


by Amy Lynn Sorrel Photos by Brett Buchanan June 2014 TEXAS MEDICINE 21


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60