APA Practice Organization continues Medicare payment reform advocacy

May 29 letter responds to specific questions from Congress related to provider reimbursement.

By Government Relations staff

In January, Congress acted once again to delay a drastic 26.5 percent Medicare provider payment cut until the end of 2013 and vowed to work toward permanently replacing the flawed Sustainable Growth Rate (SGR) formula. The issue of Medicare payment reform is currently being addressed in both the U.S. Senate and the House of Representatives, and relevant committees in both chambers have invited the APA Practice Organization (APAPO) and other health care organizations to address specific questions related to provider reimbursement.

On May 29, APAPO submitted suggestions about Medicare payment reform in response to a request from the Senate Finance Committee. APAPO’s proposal responded to several specific questions from the committee and mirrors the letter that APAPO sent April 11 in response to a similar request from the House Energy and Commerce and Ways and Means committees.

As part of APAPO’s ongoing participation in the national discussion about Medicare payment reform and the SGR formula, Government Relations staff have been attending hearings of the House Energy and Commerce and Ways and Means committees, and the Senate Finance Committee, to help ensure that psychology’s issues are fully addressed in reform efforts.

The May 15 Senate Finance hearing on “Advancing reform: Medicare physician payments” featured testimony from Mark E. Miller, PhD, executive director of the Medicare Payment Advisory Commission, and Kavita K. Patel, MD, MSHS, fellow and managing director at the Engelberg Center for Health Care Reform, The Brookings Institution, among others. Testimony focused on the need to repeal the SGR and shift from paying for volume of services to paying for quality and accountability.

Though movement on Medicare payment reform has been slow in the past, the Congressional Budget Office has cut in half last year’s estimate of the cost to the government of repealing the SGR formula. That cost is now estimated at $138 billion, down from more than $300 billion. The U.S. House of Representatives has taken the lead on finding alternatives to the SGR formula, and there are clear signs that Congress may finally repeal or replace it.

The May 29 letter from APAPO to the Senate Finance Committee addressed:

  • Necessary reforms to the physician fee schedule,

  • policies to ensure that health care providers’ services are valued appropriately and

  • ways that Medicare can effectively incentivize providers to make changes needed to participate in alternative payment models.

Read the full letter to the Senate Finance Committee (PDF, 140KB).

For more information, contact Government Relations staff by email or at 202-336-5889.