This week, 25 California Medical Association (CMA) physician leaders were in Washington, D.C., as part of the American Medical Association’s Legislative Week to urge Congress to enact the bipartisan, bicameral legislation that would repeal the Medicare sustainable growth rate (SGR) and institute a new payment system. The group also asked Congress to reauthorize the State Children’s Health Insurance Program, formerly known as Healthy Families, which is set to expire September 2015.

Medicare SGR

Last year, both houses of Congress were very close to a permanent repeal of the badly broken SGR formula. For the first time in a decade, House and Senate Committees had adopted a bipartisan, bicameral payment system to replace the SGR. Unfortunately, they were unable to agree on how to pay for it, ultimately passing a patch to stop the SGR-triggered payment cuts for the 17th time in 10 years.

Congressional leaders have agreed to carry the bipartisan bill forward in the new Congress and leave it intact. However, there remains strong disagreement on how to pay for the bill, despite the House and Senate leadership’s stated commitment to enact the bill this year. Fortunately, there is a growing chorus of conservative thinkers, such as the Wall Street Journal, Americans for Tax Reform and the Galen Institute, who have all told Congress that the projected SGR cuts are “phony” – lawmakers having never implemented the SGR over the last decade, instead adopting short-term patches year after year to stop the cuts – and therefore, the repeal itself does not need to be offset with corresponding funding. If Congress accepts this policy, they will only need to find an additional $30 billion to pass the bill.

Luther Cobb, M.D., CMA president, told Congress that half of California physicians are over the age of 55 and nearing retirement. Passage of Medicare payment reforms would bring the stability and resources necessary to physicians to keep them in practice. He also said that requiring financial offsets for the SGR is akin to a “pay-day loan” and a waste of federal resources. The cumulative cost of the patches now total more than the entire repeal legislation will cost. On behalf of CMA, Dr. Cobb urged Congress to move quickly to protect California’s seniors and military families.

Meaningful use reform and ICD-10

CMA physician leaders also met with Congress, the president’s Medicare staff at the White House and the new head of the Centers for Medicare and Medicaid Services (CMS), Andy Slavitt, about ICD-10 implementation and the burdensome meaningful use electronic health record program. CMA asked CMS to thoroughly test ICD-10 before implementation and suggested that if the testing shows problems, the program should be delayed. CMA physicians also vigorously urged immediate and sweeping reform to the meaningful use program, with Dr. Cobb telling key decision-makers that while the program was intended to facilitate the exchange of patient information to improve care,  it has only hindered participation in the program, imposed unnecessary administrative burdens, disrupted workflow, interfered with patient care and created substantial frustration among physicians. CMA urged decision-makers to require interoperability; align the quality and meaningful use reporting programs; eliminate the all-or-nothing approach, allowing physicians to get credit for the requirements they have met; eliminate the measures that are beyond a physician’s control, such as the patient portal; provide timely feedback; and get rid of the penalties.

Contact: Elizabeth McNeil, emcneil@cmadocs.org.