Congressional Passage Of Medicare Physician Payment Legislation Needed To Prevent 21 Percent Cut In Payments

The American Psychiatric Association is urging Congress to pass
legislation to halt the 21 percent cut to physician payments for Medicare scheduled to take effect April 1.

The APA also joins the American Medical Association in urging Congress to permanently fix the
Sustainable Growth Rate (SGR) problem to ensure a stable Medicare program. As a result of the SGR, a
flaw in the complex Medicare payment formula that automatically creates huge annual cuts, Congress has
had to act every year since 2003 to postpone implementation. The current price instability makes it
impossible for psychiatrists and other physicians to depend on Medicare payments, which undermines
access to care for patients.

The APA calls on Congress to act to prevent a 21 percent reduction in the Medicare SGR payment update
which is scheduled to go into effect April 1. Congress has already twice postponed the cut (originally slated
to go into effect on January 1) and the House has already approved legislation (H.R. 4851) that would
postpone the reduction until May 1. The legislation must now be approved by the Senate, which will require
60 votes to invoke cloture and to stop a filibuster by Sen. Tom Coburn, R- Okla. The Senate cloture vote is
scheduled for April 12 after members return from a two-week spring recess.

The Centers for Medicare and Medicaid Services (CMS) is instructing contractors to hold Medicare claims
for the first 10 business days of April in order to give Congress time to pass legislation postponing the cut.
Should the cuts go into force, the APA is asking Congress to restore any lost payments retroactive to April

“We’re disappointed that the Senate failed to act to block the SGR cut before taking a two week break,” said
Nicholas Meyers, director of the APA Department of Government Relations. “Although the action by CMS
is appreciated, this latest scramble only underscores the need for Congress to fix the SGR permanently. The
current situation is unacceptable and jeopardizes patient access to care.”
Additional information is available in an APA Fact Sheet on the SGR.

American Psychiatric Association

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