Repealing the Sustainable Growth Rate, gestational diabetes, more residency positions for ob.gyns., and reducing liability were on the minds of ob.gyns. at the Congressional Leadership Conference this year.
Approximately 400 ob.gyns. attended the 32nd annual American College of Obstetricians and Gynecologists Congressional Leadership Conference (CLC) in Washington, D.C., during March 2-4. Forty-nine states plus Puerto Rico; Washington, D.C.; and Ontario were represented. The attendees learned about pending legislation and subsequently lobbied their legislators in Congress for their cosponsorship of four bills.
While Congress met the April 1 deadline to avoid the 24% Medicare pay cut called for by the Sustainable Growth Rate (SGR) formula, it did so via a 1-year patch and not by passing the comprehensive reform favored by many physicians. The SGR has created financial instability in health care. More than $150 billion has been spent to avoid physician payment cuts and the temporary patch will increase that cost. CLC attendees had asked their representatives and senators to cosponsor the Sustainable Growth Rate Repeal and Medicare Provider Modernization Act of 2014 (H.R. 4015). This bill would repeal the SGR and guarantee physicians 5 years of payment increases at 0.5% per year. The House passed H.R. 4015, but a modification was introduced and passed by a voice vote. That is the bill that ultimately went to the Senate and was passed, and that President Obama signed.
The Gestational Diabetes Act of 2013 (H.R. 1915/S. 907) provides funding for research and surveillance to improve screening for gestational diabetes and track women who have this diagnosis. This disease is estimated to affect 18% of all pregnancies and is increasing in frequency, according to the American Diabetes Association. Currently, there is minimal research being conducted on gestational diabetes.
The Training Tomorrow’s Doctors Today Act of 2013 (H.R. 1201) provides for 15,000 additional residency positions over the next 5 years. Currently, Medicare pays $3 billion for resident salaries (direct graduate medical education) and $6.4 billion for the higher cost of patient care in teaching hospitals (indirect GME). The number of federally funded residency slots has not increased since 1997. It is anticipated that there will be an 18% shortage of ob.gyns. by 2030 and 25% by 2050 if there is no increase in residency positions, according to ACOG. This bill requires hospitals receiving federal funding to allocate 25% of residency slots to primary care and general surgery. In this bill, ob.gyn. is considered primary care. The Senate does not have a companion bill.
The Saving Lives, Saving Cost Act of 2014 (H.R. 4106) was introduced in the House by a Republican lawyer and a Democratic physician. This bill provides for the option of a review by an independent medical review panel in a medical malpractice case where adherence to approved clinical guidelines can be used as a defense. This bill strives to cut medical costs by reducing the incidence of defensive medicine and frivolous lawsuits through the establishment of quality-promoting guidelines. At the time of the CLC, this bill had recently been introduced. There is no companion bill in the Senate.
The next CLC will be March 8-10, 2015.
Dr. Bohon is the American College of Obstetricians and Gynecologists’ D.C. Section Fellow Chair and a private practice ob.gyn. in Washington. She said she had no relevant financial disclosures. E-mail her at email@example.com.
*This story was updated 4/3/2014