SGR Fix Unlikely This Year, Sen. Kyl Says



WASHINGTON – Stop focusing on replacing the Medicare Sustainable Growth Rate formula and instead look at getting the best possible Medicare physician fee update for the longest period of time.

That was the advice Sen. Jon Kyl (R-Ariz.) gave to physicians Feb. 14 at a national advocacy conference sponsored by the American Medical Association.

Sen. Kyl serves on the House/Senate conference committee charged with crafting a plan to extend the payroll tax holiday and benefits for the long-term unemployed. An SGR fix was tacked onto short-term legislation to extend those provisions in December; those fixes expire Feb. 29.

It is unlikely that the conference committee will agree to repeal the SGR this year, Sen. Kyl said. In fact, the panel is currently looking at "de-coupling" an SGR fix from the two other provisions.

"These issues are in play: How long will the [physician fee] update be and will it be on the positive side?" he said. "I urge you ... to focus your attention on those two issues."

Sen. Jon Kyl (R-Ariz.)

He added that he supports using monies not spent on the wars in Iraq and Afghanistan (officially called Oversees Contingency Operations [OCO] funds) to eliminate debt that would be incurred by a permanent and full SGR replacement.

But that won’t be enough to solve the whole problem, he said.

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"There is a good chance that we can eliminate the almost $200 billion of past debt with these ‘phony savings’ " from OCO, Sen Kyl said. "But you still have $100 billion of real payments to real doctors and that has to be real money; that can’t be phony."

The AMA has been advocating for full repeal of the Sustainable Growth Rate formula, and the use of OCO money to fund it. Dr. Robert Wah, chair of the AMA Board of Trustees, said the organization remains cautiously optimistic about whether Congress will take action this year.

"[I’m encouraged by] the fact that we’re hearing the word ‘OCO’ and we’re hearing the word ‘elimination’ and ‘permanent repeal of SGR,’ " Dr. Wah said in an interview. "But whether or not all those talking words result in action is yet to be determined."

According to Sen. Kyl, the conference committee could release a decision on any changes to the SGR shortly. He added that the committee will have to compromise between the 10-month update supported by its Democratic members and the 2-year update proposed by its Republican members.

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