Effort looks to war savings for SGR replacement
Lawmakers urged to use war savings to scrap SGR and find replacement READ The “Window on Washington” blog at modernhealthcare.com/washington
Lawmakers hashing out yet another temporary patch to prevent big cuts in Medicare’s pay for physicians may have a narrow window to scrap the entire controversial formula. Many provider groups are pushing federal legislators to seize the opportunity.
A scenario for jettisoning Medicare’s sustainable growth-rate formula emerged amid recently launched talks over House-passed legislation that would delay a scheduled 27.4% cut for two years. Instead of another pay patch, Democrats have urged the use of one-time savings from the end of the Iraq War to cover the cost of replacing the formula.
Some leading provider groups have joined that effort as a way to avoid the cuts to nonphysician providers—whose reimbursement was reduced to pay for the patch—and as a fleeting chance to end the yearslong drama of Congress scrambling to avert a cycle of looming cuts.
“We’ve talked to a number of Republican offices” about the proposal to scrap the SGR, said Anders Gilberg, senior vice president of government affairs for the MGMA. “They’re not completely opposed to the idea of it, so that’s what we’re pursuing.”
Republicans, especially the members of the GOP Doctors Caucus, said they strongly support replacing the SGR but doing so in a fiscally responsible way.
Critics of the claimed savings from war spending, known as Overseas Contingency Operations funding, describe it as an accounting gimmick that exists only on congressional budget documents that automatically project forward all current spending as ongoing. Those projections will disappear when Congress passes a new defense spending bill.
But proponents of using that savings—sufficient to cover the nearly $300 billion 10-year cost of replacing the Sgr—view it as appropriate because they say the Medicare physician formula also amounts to an accounting gimmick. That is, Congress created the SGR formula as a way to constrain the growth of the program, but Congress has repeatedly waived it over the last decade and its members widely view implementing such cuts as unrealistic.
The use of the war offsets is apparently gaining ground among congressional Republicans, with several reporting that they support using some version of the funding for a permanent repeal.
“Momentum is building to use the war sav-