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SGR remains focal point of docs' ire at AMA meeting

A major theme of American Medical Association President Dr. Ardis Dee Hoven's address at the opening session of the AMA House of Delegates meeting in Chicago was a familiar one: Congress let doctors and senior citizens down when they once again failed to pass Medicare payment reform.

This spring, Congress was poised to repeal the hated Medicare sustainable growth-rate physician payment formula, which mandates huge cuts in physician reimbursement each year. But, after partisan disagreements developed over how to pay for an SGR replacement, Congress instead passed its 17th temporary legislative SGR “patch” which froze Medicare pay rates through March 2015 and kicked the decision-making can down the road yet another time.

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Hoven, an infectious disease expert whose term as president ends June 10, said that the SGR repeal effort wasn't a total waste. She highlighted how a physician task force developed a set of principles for SGR replacement that was then endorsed by 100 physician organizations. The principles were then incorporated into a bill with bipartisan, bicameral support.

“I saw politicians on both sides of the aisle—in the Senate and the House—voice their approval for the legislation,” Hoven said. “I saw them look me in the eye and tell me they would get it done. And then, a few weeks later, I saw those same politicians vote that bill down.”

Hoven, who was No. 5 on Modern Healthcare's list of the 50 Most Influential Physician Executives and Leaders, was applauded when she said it wasn't the AMA that failed to take advantage of the “unprecedented opportunity to fix Medicare.” It was Congress that failed.

“We physicians are held accountable every day,” she added. “It's time Congress was held accountable, too. We need to let Congress know that business as usual is unacceptable.”

Speaker of the House of Delegates Dr. Andrew Gurman is known for starting the annual meetings with a humorous video. This year, however, he showed a video produced by the American Academy of Otolaryngology—Head and Neck Surgery that summarized doctors' disgust with Congress over the latest SGR failure.

The short-and-simple video tells how it took 12 years for Congress to get serious about repealing the SGR and how it took 12 months to write a bipartisan bill that everyone could agree on, Then the video has a clip of how the bill was killed in Congress during a 24-second parliamentary procedure.

It was up to Dr. John Poole, chairman of the board for AMPAC the AMA's political action committee, to inject some humor.

Poole, a laparoscopic surgeon and marathoner from Ridgewood, N.J., gave his report while wearing a running suit.

“If you're in medicine, you're in politics—especially now,” Poole said.

Poole added that the first thing you have to do to prepare for a marathon is enter the race, but only 49% of AMA delegates have contributed to AMPAC.

“That's embarrassing,” he said.

If anything, he said, doctors have to stay in the SGR race because other stakeholders with competing interests—such as lawyers and pharmaceutical companies—have not dropped out.

“If the house of medicine isn't completely united, we're going to be in big trouble,” Poole said.

Political contributions have not always translated into political support on the SGR. The most notable case was in 2010 when former Sen. Jim Bunning (R-Ky.) filibustered to block patching a 21.2% SGR-driven Medicare pay cut. The pay cut went into effect on March 1, but Congress wound up passing another “doc fix” the next day.

“Health professionals” helped elect Bunning, a baseball Hall of Fame pitcher, by donating $194,883 in individual donations and $141,948 in PAC donations to his 2004 campaign. He won by 51-to-49 margin over Dr. Dan Mongiardo, a throat surgeon, who voted against a cap on punitive malpractice damages while serving in the Kentucky state senate.

Follow Andis Robeznieks on Twitter: @MHARobeznieks



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