In the final hours of the lame duck session, Congress passed a $1.01 trillion spending bill that will keep most of the federal government funded through next September, but it failed to pass a fix for the Medicare sustainable growth rate (SGR). Congress will leave it to be addressed before the April 1 deadline next year, when physicians will be faced with a 21 percent payment cut.

Unfortunately, Congress will begin anew with many new members who have not been a part of the bipartisan, bicameral SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015/S. 2000), which offered a fiscally prudent opportunity for lawmakers to repeal the SGR formula and put Medicare on the path toward a stable, 21st-century program that helps physicians maintain their practices and meets the growing health care needs of the nation’s seniors.

Three committees came to an agreement on reform in 2014, but the new year will bring not only new members, but new committee chairs. However, most of the new committee leadership on both sides of the aisle have said they will likely continue to support the SGR bill.

While Congress’s inability to address this issue once again is frustrating, there continues to be momentum on the SGR. Significant progress is being made on the funding – a point of contention that led to the 17th SGR patch earlier in 2014.

Working to build on the momentum of the Medicare payment policy agreement and the new emerging consensus that the SGR repeal does not need to be offset with other funding, the California Medical Association (CMA) will make Medicare payment reform a major priority again in 2015. However, there will be limited time after the new Congress convenes before the current SGR patch expires on April 1. The House of Representatives is only scheduled to be in session for 37 days before the 21 percent SGR cut takes effect.

CMA leadership will be in Washington, D.C., in February. We will also be asking physicians to meet with their Members of Congress while they in their home districts in January. And CMA will launch a major physician and patient grassroots campaign. The California Members of Congress need to continue to hear from their physician constituents. We have never been so close to repealing and replacing the SGR, but we must keep the issue on Congress’s front burner. Otherwise, immigration reform, conflicts around the world and budget issues will consume all of their time and attention.

In addition to inaction on SGR, Congress also failed in the lame duck session to extend the Affordable Care Act (ACA) Medicaid (Medi-Cal) primary care rate increase that expires at the end of 2014. We will be pushing Congress to extend this crucial rate increase.

Physicians are hopeful that Congress will build on the progress made this year so that organized medicine can focus on addressing other important health policy issues. Critical health care issues facing Congress next year include the expiring Healthy Families program, graduate medical education, telemedicine and improvements to the ACA.

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