Internists plead Congress to avert scheduled Medicare SGR cut

Video features geographic and specialty range of ACP members citing impact of cuts

The American College of Physicians (ACP) today is sending a video to Congressional leaders and others that features internists - speaking in their own words (http://www.acponline.org/advocacy/video/sgr.htm) - issuing a heartfelt plea for Congress to avert the scheduled Medicare Sustainable Growth Rate (SGR) cut and work toward putting an end to the repeated cycle of cuts. The 3-minute and 25-second video emphasizes how patients, in particular, will be hurt by the scheduled cuts.

The 23 percent physician payment cut is scheduled to take place on Dec. 1. Three times before in 2010, reprieves as brief as one month have staved off cuts before they could take effect with some being provided retroactively. While Congress continues to work toward a further delay of the cuts, lawmakers have yet to agree on a pathway toward repeal of the flawed SGR system once and for all.

In a blog last month (http://advocacyblog.acponline.org/2010/10/breaking-through-legislative-firewall.html), Robert B. Doherty, ACP senior vice president, Governmental Affairs and Public Policy pointed out:

It is especially hard to get your voices heard when it involves a recurring issue, like the Medicare SGR formula, where everything seemingly has been said so many times before. Lawmakers don't expect to hear anything new from constituents, and constituents get tired of sending yet another e-mail or letter, when it seems likely that the result is more of the same.

ACP, Doherty wrote, is trying a new way to break through to Congress. The video combines old-fashioned story-telling, e-mail, and the kind of video link popularized by YouTube.

"The video may not be as entertaining as standard YouTube fare," said J. Fred Ralston Jr. MD, FACP, president of ACP, "but I think it makes an extraordinarily heartfelt and effective case on why Congress needs to stop the Medicare SGR cuts."

ACP's state chapter leaders (ACP governors) were asked to record short video messages, that would explain - in their own words - the impact of the Medicare SGR cuts on their patients, practices, colleagues and communities. The in-house-produced video shows 10 physicians talking about their real-life situations. They are physicians from different parts of the country, many of whom have different specialties and treat different kinds of patients. The physicians, like the patients they treat, are of varying ages and have varying experience in treating chronic conditions.

They all agree that the SGR has a great impact on both their own and their patients' lives.

On Nov. 18, the Senate unanimously approved legislation that would avert the Medicare payment cut scheduled for Dec. 1. House leaders say they anticipate taking up and passing identical legislation this week.

However, the proposed legislation only extends current payment rates for 30 days. It does allow Congress additional time before the end of the year to prevent what would be a 25 percent cut on Jan. 1.

In the late spring of this year, when Congress also "kicked the can down the road" with a temporary fix, Ralston noted that:

"-the fact remains that time-and-time again, too many members of Congress from both political parties have refused to support legislation to prevent the cut and provide long-term stability in Medicare.

"They have declined to support legislation to move toward a better and more stable payment system, which could have served as the basis for permanent repeal of the unworkable Sustainable Growth Rate (SGR) formula.

"They have withheld their support even though they knew that the result will be to further undermine physicians' and patients' faith in Medicare-

"They withheld their support, even though they knew it would introduce chaos into physician practices. Physicians, once again, are left with trying to keep their doors open for their patients without knowing, from month to month, how much Medicare- will reimburse them for their services."

ACP notes on its website that it is dismayed that this all-too-common scenario continues to surface, threatening access to care for beneficiaries and wreaking havoc on physician practices. The College is doing all it can - including use of this new video - to realize a legislative intervention that is viable for practices and of the longest duration possible under the current challenging legislative environment. ACP continues to urge Congress to enact legislation that provides relief from SGR cuts at least through December 31, 2011, as an essential step to permanent repeal.