Congress passes

January 27, 2008

Unable to reach consensus on a meaningful Medicare reform package, Congressional leaders and the Bush Administration have cobbled together a last–minute, barebones package to temporarily avert the 10% across-the-board Medicare physician payment cut scheduled to take effect on January 1, 2008.  President Bush is expected to sign the bill into law soon.

The final package contains provisions that will replace the scheduled payment cut with a 0.5% payment increase for 6 months – until June 30, 2008.  Significant cuts remain scheduled for the remainder of 2008 and beyond.

Despite hundreds of hours of negotiation leading up to this week, Congressional leaders were unable to reach agreement with the Bush Administration on a package containing a multi-year fix to the Sustainable Growth Rate (SGR) formula and a pathway to eliminate the SGR as a physician update mechanism.  Key lawmakers had sought to use excess payments to Medicare Advantage (MA) managed care plans to finance a larger more permanent fix to the Medicare physician payment problem.  The Bush Administration objected to any effort to shift excess MA plan payments to physician payments thereby halting all progress on the package.

The .5% positive update will slightly increase the 32% anesthesia work value increase recently announced by CMS.  ASA will provide its members with more information once CMS calculates the new Medicare anesthesia conversion factors for 2008.  

ASA believes that the Administration should be more flexible in allowing responsible changes to thriving Medicare Advantage plans for the sake of providing fair Medicare payment to physicians.  Continued years of minimal, flat or negative updates could seriously hinder patient access to medical care nationwide.

Because Congress must re-address the SGR issue midyear, ASA and others in organized medicine will redouble efforts to fully overturn SGR-imposed cuts slated for the coming years.  Further, we will continue working toward a restoration of Medicare payments for anesthesiology teaching programs through enactment of H.R. 2053 and S. 2056.

ASA members are strongly encouraged to contact their Representative and Senators through the Capitol Switchboard, (202) 225-3121, to ask for permanent, meaningful Medicare payment reform and a fix for the Medicare anesthesiology teaching rule.  Please check www.ASAhq.org frequently for updates and action alerts.

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