The week of February 11, California Medical Association (CMA) physician officers, leaders and medical students/residents, will visit Washington, D.C., to push members of Congress for a number of reforms, including a repeal of the sustainable growth rate (SGR).

This comes on the heels of a recent report by the Congressional Budget Office that showed the cost of a permanent fix to the Medicare SGR as dramatically lower than previous estimates. The estimated price tag is $138 billion over 10 years, $100 billion less than previous estimates (see CBO story). Currently there are several bills in Congress that would adopt a new Medicare payment system.

The CMA delegation expects to seize the moment and preview for Congress an alternative Medicare payment system that CMA, the American Medical Association and health care organizations have been working on over the past year. With the goal of creating a stable payment system that promotes quality and value in health care, the proposed system would provide a menu of payment methods and health delivery models in which physicians could choose to participate, such as primary care medical homes and patient registries to track outcomes.

With Medicare spending growth down to the lowest levels in decades, CMA will be urging members of Congress to seize the opportunity to enact long-term physician payment reforms so California physicians can meet their commitments to their patients.

The CMA delegation will also urge Congress to stop the budget sequestration cuts that are set to take place on March 1. Sequestration is a series of draconian budget cuts that will total $1.2 trillion. These cuts are evenly split between defense and domestic discretionary spending (with some exemptions, such as Social Security, Medicaid and veterans' benefits). Two percent will be cut across the board from all discretionary programs, including Medicare physician payments (which already lag behind practice cost inflation by 20 percent), graduate medical education and federal public health institutions including the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration and the National Institutes of Medicine.

Other issues that the CMA delegation expects to take up with members of Congress include, updating the Medicare payment regions to Metropolitan Statistical Areas; immigration reform to expand the number of J-1 Visa waivers for foreign physicians who are licensed and received graduate training in the U.S.; lifting the cap on graduate medical education residency positions to meet the future demands of health reform; combating prescription drug abuse; and Medicare private contracting.

The CMA delegation will also be discussing California-specific issues, including Medi-Cal expansion and the state proposed 10 percent reimbursement cut; monitoring of exchange plan network adequacy; and the state's ill-advised dual eligible demonstration project.

Contact: Elizabeth McNeil, (800) 786-4262 or emcneil@cmadocs.org.