Congress Averts 24% Cut to Medicare Payments, Delays ICD-10
On April 1, the U.S. Congress averted a 24% cut to Medicare physician payments caused by the flawed sustainable growth rate (SGR) formula. The Protecting Access to Medicare Act of 2014 delays the double-digit cuts until March 31, 2015, and calls for a 0.5% update to physician payment rates until December 31, 2014. The legislation also delays the implementation of the new ICD-10 coding system until October 1, 2015.
The passage of the one-year patch — known as the “doc fix”— marks the 17th time that Congress has voted to temporarily delay the SGR cuts since 2003. Congress has spent nearly $154 billion on temporary fixes in that time, a figure which now exceeds the $124 billion it would cost to permanently repeal the formula.
Over the past six months, Congress had been making considerable headway in developing a framework to permanently repeal the SGR. Bipartisan, bicameral legislation outlining new healthcare delivery and payment models for Medicare was introduced in both the House and Senate for the first time this year and was widely supported by the healthcare community. This legislation, combined with a projection that the SGR repeal would cost far less than anticipated, led many to believe that a permanent fix might be viable.
However, in the days leading up to the April 1 deadline, House Republicans added an amendment to the bipartisan, bicameral legislation that would delay the Affordable Care Act’s individual mandate to help pay for the SGR repeal. Senate Democrats avowed that any delay of the individual mandate would not be considered and instead proposed using excess funds from the wars in Iraq and Afghanistan — a nonstarter in the House. With Congress at an impasse on how to offset the costs and physician organizations aggressively lobbying against another patch, it was unclear if Congress could pass even a temporary fix before the deadline.
Behind the scenes, House and Senate leaders were negotiating a plan. The House needed two-thirds of its members to vote in support of the temporary patch for it to pass. With at least 50 Democrats opposing a patch in favor of a permanent repeal, it was unclear if the votes were there. Through a series of tricky, procedural maneuvers, House leaders called for a temporary recess and then passed the temporary patch with a voice vote behind closed doors. Four days later, with just hours before the April 1 deadline, the “doc fix” also passed the Senate, averting the 24% cut.
While the Society is pleased that cuts to physician payments were prevented, it will continue to urge Congress to pass a permanent solution as soon as possible. Take action: Visit the Society’s online advocacy center at http://www.endocrine.org/advocacy-andoutreach/take-action to urge Congress to pass a permanent repeal now.
Society Works to Influence Appropriations
Process to Support NIH Funding
Spring time in Washington, and along with the blooming cherry blossom trees and hordes of tourists visiting the nation’s capital, congressional appropriations committees are considering funding levels for competing budgetary priorities. Within this challenging fiscal environment, the Endocrine Society has intensified its efforts to advocate for increased federal funding for biomedical research by employing several tactics to encourage adequate funding levels for the National Institutes of Health (NIH), including:
• Conducting an Endocrine Society Researcher Capitol Hill Day on March 27;
• Developing “grassroots” advocacy tools for Endocrine Society members to use with their congressional delegations;
• Submitting testimony to the House and Senate Labor, Health and Human Services, Education and Related Agencies Appropriations Subcommittee; and
• Taking a leading role with advocacy coalitions.
Researcher Hill Day
On March 27, the Endocrine Society brought researchers from the Advocacy and Public Outreach Core Committee (APOCC) and the Research Affairs Core Committee (RACC) to Washington to meet with Members of Congress and discuss funding for the NIH and the value of federally supported endocrine research. Society members had a great opportunity to educate congressional offices about endocrine-related research as they urged offices to support an overall funding level of $32 billion for the NIH. Reaction from all offices visited was positive with several representatives and senators agreeing to support the Society’s recommended funding request. “Participating in Hill Day was an incredible opportunity. I felt that meeting directly with our leaders made a real difference for researchers in the Endocrine Society” says Corrine Welt, MD, co-chair of the RACC.
Grassroots Advocacy Tools
Now is the time for all members of the Society to join Society advocacy campaigns. We urge all members to contact their representatives and senators to explain the value of biomedical research and ask them to increase NIH funding during the appropriations process. Please visit the Endocrine Society’s NIH Funding Advocacy Toolkit at www.endocrine.org to join the Society’s online advocacy campaign and explore other ways to help the Society advocate for biomedical research in the U.S. The help of members is critical to the success of Society advocacy efforts.
Appropriations Testimony
The Society submitted written testimony to the House Appropriations Committee highlighting advances made in the past year by endocrinologists and other NIH-supported researchers and emphasizing the social and economic value of federal funding for biomedical research. The Society also expressed strong concern about the ongoing impacts of a decade of flat funding for the NIH, combined with austerity measures such as sequestration and mandatory budget caps. The testimony described the economic damage and missed opportunities due to persistent underinvestment in research. A copy of the testimony is available on the Society’s website at www.endocrine.org under the Advocacy & Outreach tab. The Society will submit similar testimony to the Senate Appropriations Committee in May.
Advocacy Coalitions
The Endocrine Society continues to work with advocacy partners, such as the Federation of American Societies for Experimental Biology, Coalition for Health Funding, and United for Medical Research on supporting funding for biomedical research during this critical period in the appropriations process. As a result of these efforts, 186 members of Congress signed on to a letter supporting $32 billion for the NIH in fiscal year (FY) 2015. The letter, generated by Reps. David McKinley (R-WV), Andre Carson (D-IN), Susan Davis (D-CA), and Pete King (R-NY), highlights many concerns expressed by the Endocrine Society in testimony and during the Hill Day. Specifically, the letter notes falling grant success rates caused by stagnating budgets that fail to keep pace with inflation.
Funding Outlook
While the life-saving research done by the NIH typically enjoys strong bipartisan support, austerity measures and budget cuts continue to threaten federally funded biomedical research programs. For example, a recent budget resolution proposed by Rep. Paul Ryan (R-WI) and passed by a 219-205 vote in the House of Representatives recommends significant reductions in nondefense discretionary spending. Although the budget is unlikely to pass the Senate, the resolution threatens to introduce a spending framework that would result in an 8.6% cut to nondefense discretionary spending in FY 2016, according to www.aaas.org. Because federal investment in biomedical research typically comes from the nondefense discretionary budget, the House budget resolution would almost certainly result in severe cuts to the NIH. Consequently, there is still more to do to educate Congress about the value of federal funding for biomedical research, in general, and endocrine-related research specifically. The Society will continue its efforts. For more information, please contact Joe Laakso at [email protected].
— Joseph M. Laakso, PhD, is manager, science policy at the Endocrine Society
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