Annals of Long Term Care

At Urging of AGS and Others, Congress Reverses 21% Medicare Pay Cut for Physicians, Substituting 2.2% Increase Through November

At the urging of the American Geriatrics Society and other national organizations, the House of Representatives followed the Senate’s lead and voted June 25 to reverse a 21% cut in Medicare payments to physicians that had taken effect June 1.

Medicare’s problematic Sustainable Growth Rate (SGR) formula, which mandates cuts in payments to physicians whenever annual outlays for these services exceed a given benchmark, triggered the cut as it has every year for the last several years. This year, as in previous years, the AGS launched concerted advocacy campaigns urging Congress to avert a SGR-mandated cutback and find a viable alternative to the formula. After the cutback took effect, the AGS launched advocacy campaigns calling for its repeal and reiterating the need for an alternative formula.

The Senate voted on June 18 to both reverse and postpone the cut through November 30 and to institute a 2.2% physician pay increase retroactive to June 1 and effective through the end of November. The House followed suit a week later, and the Centers for Medicare & Medicaid Services (CMS) began adjusting payments to physicians who billed Medicare for services provided between June 1 and June 25 and requested adjustments. Practices must request the adjustments, which will reflect the 2.2% increase, effective as of June 1, rather than the 21% cut.

“The American Geriatrics Society will continue to urge Congress to come up with a permanent alternative to the SGR—an alternative payment protocol that will provide physicians with viable reimbursement for the care they provide Medicare beneficiaries,” AGS President Sharon A. Brangman, MD, said following the late June vote.

The AGS is encouraging its members to share with them stories about how the SGR has affected their practices and the care of older patients. The AGS plans, in turn, to share these stories in meetings with lawmakers and their staff prior to November 30 to impress upon Congress the urgency of finding a workable alternative to the SGR. If you would like to participate in this effort, please contact Susan Sherman at ssherman@americangeriatrics.org or at 212-308-1414.

AGS Supports Donald M. Berwick, MD's Nomination for Administrator of the Centers for Medicare & Medicaid Services and Applauds His Appointment

The AGS announced its support for the nomination of Donald M. Berwick, MD, as administrator of the Centers for Medicare & Medicaid Services (CMS) in late June.

“We are certain that Dr. Berwick's work to advance quality and patient safety will benefit the millions of older Americans served by Medicare,” said AGS President Sharon A. Brangman, MD, who, in a letter to Senate Finance Committee Chair Sen. Max Baucus, expressed confidence that Dr. Berwick “will support and advance policies that address older Americans, who often suffer from multiple chronic conditions and frailty issues that present challenges to their ability to obtain high quality, appropriate medical care.”

One of the nation’s leading authorities on healthcare quality improvement, Dr. Berwick is President and Chief Executive Officer of the Institute for Healthcare Improvement (IHI). He is also a Clinical Professor of Pediatrics and Health Care Policy at Harvard Medical School and a Professor of Health Policy and Management at the Harvard School of Public Health. His appointment runs through late 2011.

EWA Delegation, Including AGS’ Michael Malone, Meets with Sen. Kohl, Urges Adequate Funding for Title VII And VIII Geriatrics Programs

The Eldercare Workforce Alliance (EWA), co-chaired by AGS Deputy Executive Vice President and COO Nancy Lundebjerg, MPH, and Steven Dawson, President of PHI, hosted a delegation of Wisconsin constituents who met with Sen.