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    American Urological Association reiterates call for permanent sustainable growth rate formula fix

    Urologists could face 32% Medicare reimbursement cut in 2013

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    Washington—Although urologists who treat Medicare patients will not face sharp fee reductions this year because of yet another stopgap action taken by Congress in February, even steeper cuts are on tap for next January unless the new Congress comes to the rescue.


    Bob Gatty
    And while the AUA and other physician organizations continue to lobby for a long-term solution, they are hoping that lawmakers do not take the advice of the Medicare Payment Advisory Commission (MedPAC) for providing a long-term solution—cutting fees for specialists by 5.9% per year for 3 years and then holding them flat for 7 more years. This would happen while primary care physicians' fees would be held flat for a decade.

    Certainly, physicians are tired of temporary reprieves even though they are grateful that Congress in mid-February approved another one, this time delaying for 10 months the scheduled 27.4% cut in Medicare doc payments that was set to begin March 1.

    When that was passed, AUA President Sushil I. Lacy, MD, said in a statement that the AUA was "extremely disappointed in our elected officials, who have once again failed to correct the SGR [sustainable growth rate formula]," which he said is "a fatally flawed payment system that has failed to keep pace with the cost of doing business in this country."

    "The SGR is a tremendous burden to physicians who struggle each year to keep their office doors open and provide ongoing quality care to seniors," Dr. Lacy said.

    Dr. Lacy said the AUA is thankful that the huge threatened cut won't be imposed, but expressed disappointment that lawmakers failed to address the underlying problem of the SGR, which requires the Centers for Medicare & Medicaid Services each year to impose steeper and steeper cuts, which are then followed by temporary reprieves by Congress. The result: The cost of reform continues to increase.

    Dr. Lacy said the AUA remains committed "to working with lawmakers to find a long-term solution to this problem."

    This latest fix was included as part of the Middle Class Tax Relief and Job Creation Act of 2012, which extended a payroll tax cut that was due to expire. The House-Senate conference committee that struck the deal considered allocating unspent overseas war funds to cover the more than $300 billion cost of repealing the SGR, but that proposal fizzled. Now, the American Medical Association says, the cost of SGR repeal will increase by another $25 billion next year.

    Ultimately, all Congress did was delay the tough decisions on how to deal with the problem until after the election. No lawmaker up for re-election wanted his physician constituents, or his Medicare patients, complaining about this during this fall's campaign.

    Now the ante is even higher because this latest extension, which runs out next January, will mean at least a 32% pay cut unless the issue is quickly settled. Because that increase is slated to take effect in January, another temporary reprieve could well be in the offing to give lawmakers time to negotiate a long-term solution.

    Then, where will lawmakers turn for advice? Will they listen to MedPAC?

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    Bob Gatty
    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.

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