The leadership of the House and Senate have been working on a patch to the looming Medicare physician fee cut of 21.2% effective June 1, 2010. The plan being discussed would patch the sustainable growth rate (SGR) for 5 years, with slight annual increases over this time period. This plan is part of a bill that includes tax extension benefits and other provisions.

The problem is that the House does not yet have the votes needed to pass this legislation. Members are objecting to the cost of the bill, including the 5-year SGR patch, as adding to the federal deficit. Yesterday, the AMA came out publically as not supporting this patch solution.  However, a total repeal of the SGR is unlikely because it would cost close to $300 billion, significantly more than the $88 billion price tag to do a 5-year patch.

Even if the House can move this bill and pass it, it is expected that it will be tougher in the Senate to find the needed votes. However, things are very fluid on Capitol Hill and there are more media reports about physicians already not accepting Medicare patients. You can read reports of this on the COA website at http://www.communityoncology.org under the news sections.

Once again, medical practices are coming down to the wire not knowing if their Medicare payments will be cut by 21.2% in less than 2 weeks. This is an impossible way to operate a practice, and continues to be irresponsible action on the part of the Congress. We understand this and COA has been advocating on this issue and the specific payment cuts to oncology.

So that you clearly understand the issues and problems, we have summarized them as follows:

1. A 21.2% Medicare fee cut will be effective on 6/1 if Congress does not act.
2. This fee cut will affect all private payer contracts paying Medicare-based rates, depending on the terms of your contracts.
3. Members are increasingly standing up to spending that increases the federal deficit.
4. The results of last night’s elections complicate everything and may likely create more gridlock.
5. Possibilities to negotiate the SGR patch include a combination of less years (at least 3, to get past the 2012 elections) and no/less annual increases.

Understand that even if a 5-year patch is passed, it sets up an estimated 37% fee cut effective 2015. At that time, principal oversight of Medicare spending will be in the hands of the Independent Payment Advisory Board, which was created by health care reform law.

Reach out to your members of Congress now, push the Stop Cancer Care Cuts petition, and come to Capitol Hill on June 23rd! Information and registration for the June 23rd Hill day are on the COA website, as are the online and paper versions of the petition.

Remember the oncology demonstration project? It was implemented in 2004 before the elections because community oncology came together in a massive out reach to their members. Most recently, the severe oncology-specific cuts for 2010 were averted because of the same out reach to members.

Please join together at this critical time!