We write to you today urging you to consider and pass bipartisan-bicameral legislation to repeal the flawed Medicare Sustainable Growth Rate (SGR) formula, reform payment for physicians and other health professionals, and address the equally important healthcare “extenders,” during the lame duck session of Congress.
As you are well aware, Congress has struggled with the threat that the SGR formula poses to reimbursement for physicians and other health professionals and to access to care for seniors and disabled Americans. Sixteen temporary legislative SGR patches have been enacted since 2003.
Unfortunately, while Congress has long debated and acknowledged the flaws of the SGR formula, these repeated short-term patches leave healthcare providers uncertain about payment rates they will receive year after year. Without both repeal of SGR and broader improvements to reimbursement, Medicare payment policy will continue to disadvantage physicians and health professionals who provide better care at lower costs. The result of this volume centric approach will be ever-increasing costs for consumers, employers and taxpayers. We note that far more federal dollars have been spent through these short-term patches than what would have been spent if long ago the formula had been addressed permanently.
We are encouraged that–for the first time since problems arose from the SGR–Congress has developed comprehensive bipartisan, bicameral legislation, with input from stakeholders, to permanently fix the formula and better reward providers for improvements in patient care.
Congress has a unique opportunity to act during the lame duck session of Congress to pass this vitally important legislation and start the 114th Congress without another looming SGR deadline.
We urge you to work together to enact permanent SGR repeal, payment reform and extenders legislation, and stand ready to work with you to achieve that goal.