Unless Congress takes action by March 31, 2015, doctors who treat Medicare patients will see a 21% payment cut due to the current physician payment formula called the "sustainable growth rate" or "SGR." Lawmakers have deferred the cuts prescribed by this 1997 reimbursement formula 17 times. These “patches” have been temporary because Congress has not been able to agree on how to pay for, or offset, a permanent fix.
As of mid-March, the House of Representatives is negotiating a legislative package that would permanently repeal and replace the SGR, and partially offset the costs of doing so. Although the details of the package have not yet been released, it appears they include provisions to shift additional costs to Medicare beneficiaries to help pay for the “Doc Fix.” Other important savings offsets, particularly relating to prescription drug pricing, are not included.
While the Center strongly believes it is in the best interest of Medicare beneficiaries and their doctors to find a permanent SGR solution, an SGR fix should not increase health care costs for people with Medicare, jeopardize access to needed care, or further diminish the already tenuous economic circumstances facing many beneficiaries. Half of all Medicare beneficiaries – more than 25 million older adults and people with disabilities – live on annual incomes of $23,500 or less, and one quarter live on $14,400 or less. Most people with Medicare cannot afford to pay more for health care.
As negotiations continue, we urge Congress to keep beneficiary concerns paramount.