Congress should erase Medicares physician payment formulaand the debt that goes with itand start from scratch, Rep. Pete Stark (D-Calif.), chairman of the House Ways and Means Health Subcommittee, said in a news conference earlier this month. Stark made this assertion in outlining his healthcare agenda in 2009, which included the physician pay fix, reauthorization of the State Childrens Health Insurance Program, promoting widespread use of health information technology, and working with the Obama administration on general healthcare reforms. Medicares sustainable growth-rate formula, or SGR, used to determine physician payments, is tied to growth in the economy and has been threatening payment reductions since 2003. Legislation approved this summer halted a 10% cut scheduled for this past July 1, and further payment reductions until the end of 2009. However, because of the snowballing effect of the SGR formula, physicians in 2010 face a 21% cut to their payments unless Congress intervenes once again. Deferring these cuts has resulted in billions of dollars in debt to the federal government. The key is getting lawmakers on the budget committees and the fiscally conservative Blue Dog Democrats to agree to forgive this so-called credit card debt, Stark says. This is old debt, a book-keeping change, Stark says. Its a special situation. Even more pressing is the reauthorization of SCHIP, he says. SCHIPs temporary extender bill expires in March, Stark says, citing Medicare Advantage overpayments and physician specialty hospitals as two likely sources for financing the bill.
Stark wants total revamp of Medicare doc pay system
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