AGA to Congress: Fix the Broken Payment System

November 14, 2013

Fixing the broken Medicare physician payment system has long been a high priority for AGA, and we’re hopeful that, between now and the end of the year, we have the best chance to date to get permanent reform. The Senate Finance Committee and the House Ways and Means Committee drafted a proposal to repeal the sustainable growth rate (SGR) formula, which dictates reimbursement.

In a letter to the committees, AGA noted that we appreciate the fact that the proposal repeals the SGR, streamlines quality reporting programs into one value-based performance (VBP) program, and provides assistance to small practices who wish to participate in alternative payment models. However, AGA is concerned that the bill provides a 10-year payment freeze for physicians and continues to add to the growing regulatory burdens that physician already face.

Since the framework does not provide legislative language and thus is lacking many details as to how this proposal would work, AGA provided suggestions on how to improve the proposal. Read AGA’s comment letter.

Next Steps
The committees now take the comments that they have received and draft legislative language for consideration. The goal of the committees is to pass this legislation before the end of the year although that may be challenging given that time is running short and there are other budgetary priorities.

The committees will also have to come up with payment offsets to finance their proposal, which could be somewhere around $150 billion over 10 years. This will be challenging since Congress is trying to reach a broad budget agreement on spending reductions and other providers such as hospitals have been vocal that they do not want to pay for the physician fix through payment reductions.

AGA plans to be actively involved in this process, advocating for the needs of the GI community. We will continue to advocate that Congress enact a permanent Medicare physician payment solution this year to ensure stability for physicians and the patients they treat.

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