MedPAC Recommendations

On October 6, the Medicare Payment Advisory Commission (MedPAC) voted to recommend that Congress repeal the Sustainable Growth Rate (SGR) formula. MedPAC is an independent body, established by Congress to address Medicare funding issues. In order to pay for the repeal, MedPAC recommended a 5.9 percent cut in payments to specialists for three years — a cumulative 18 percent cut — and a 10-year freeze on payments for primary care services. Primary care services currently would be defined as physicians whose practices’ payments are based at least 60 percent on claims for evaluation and management services.

The Commission first discussed the approach at its September meeting. HRS signed on to letters that the AMA and the Alliance for Specialty Medicine submitted vehemently opposing the funding plan. MedPAC Chair Glenn Hackbarth, JD, noted that the Commission needs to send two key messages to Congress. First, the SGR must be repealed. Second, if Congress repeals the SGR and only involves budgetary offsets from within Medicare, we will be going down a very difficult path, referring to the payment cuts and freezes.

The physician community will continue to urge Congress not to impose the cuts. Doing so will impact access to primary and specialty care while forcing physicians to pay for a flawed formula that Congress imposed on them and has failed to fix for ten years. HRS members are encouraged to contact their members of Congress to urge them not cut physician payments any further. The Society will be providing talking points for members to use in their outreach to Congressional offices.