If Medicare's sustainable growth-rate formula for paying doctors is finally repealed this week, few will mourn its demise. However, there's one notable exception: contract lobbyists, for whom the perennial Medicare payment standoff has been a financial boon for many years.
In 2014, more than 100 firms were registered to lobby on SGR, according to the Senate's lobbying disclosure database. They represented nearly 250 healthcare organizations with contracts totaling more than $30 million. Those contracts didn't just involve SGR lobbying, however. Most disclosure reports listed numerous issues of concern to lobbying firms.
“The important thing about SGR was its predictability,” said John Jonas, a partner at Akin Gump Strauss Hauer & Feld, which worked on SGR for six healthcare clients last year. “In a legislative environment that is so abnormal, or dysfunctional, or constipated, or log-jammed, or whatever word you choose, the advantage of the SGR was that there was this vehicle and there was some predictability about it.”
There probably were even more registered lobbyists working on the doc fix in recent weeks, though lobbying reports for the first quarter of 2015 aren't due until April 20, said Bill Allison, a senior fellow at the Sunlight Foundation, a government transparency advocacy group.
Firms likely scurried to add SGR to their list of disclosed lobbying topics when it became evident that the surprise deal cooked up between House Speaker John Boehner and House Minority Leader Nancy Pelosi might actually go through.
Tim LaPira, a lobbying expert at James Madison University, said lobbying firms can avoid disclosure by limiting the activities they engage in to avoid triggering filing requirements. “The lobbying disclosure database actually misses quite a bit of what the average person might think of as lobbying,” LaPira said.
Tarplin, Downs & Young, a Washington consulting and policy development firm focused on healthcare issues, had the largest book of SGR-related business in 2014. It represented 13 clients on the issue through contracts totaling $3.8 million.