Physicians urge Congress to reject proposed Medicare pay cuts

David O. Barbe, MD, MHA
Immediate Past President
American Medical Association
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The recent news from Washington reminds me of the years physicians spent fighting cuts mandated by the sustainable growth-rate formula (SGR).  The latest federal spending package for fiscal 2018 being considered by Congress includes a proposal that threatens to roll back payments to 2015 levels and undermine Medicare-improvement efforts already in progress.

Your voice is needed. Contact your senators and representative and let them know that expanding the so-called misvalued codes policy will reduce patient access. It will also erase the investment Congress made when it established a period of stability in which physicians could prepare for new payment models created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)—the legislation that repealed the SGR.


Editor's note: Late in the evening on Feb. 5, House language on the FY 2018 spending bill was made available that contained significant changes. Specifically, the misvalued codes policy extension was reduced from two years to one, so it will not produce a negative payment update in 2020.  We are still evaluating the impact on payments in 2019, as well as other health related provisions in the bill. Updated information will be available shortly. Thank you for your support.


MACRA provided for regular 0.5% payment updates to the Medicare fee schedule. Congress intended for this to provide a period of stability as physicians made the changes they need to participate in MACRA’s Medicare Merit-based Incentive Payment System or Alternative Payment Models. This includes investing in information technology and hiring staff to better manage patients’ chronic conditions to keep them healthy and out of the hospital.

Those updates have been reduced for the past three years by the existing misvalued codes policy making it harder to make those needed investments. Expanding the policy and rolling Medicare payments back to 2015 levels will certainly not help.

For more than a decade before MACRA was passed, physicians were repeatedly called to raise their voices and prevent SGR-driven Medicare payment cuts. That call is being made again. The budget proposal is expected to be voted on no later than Thursday, so it is vital that physicians express their opposition as soon as possible.

Form letters have been posted on the AMA grass roots web site at physiciansgrassrootsnetwork.org. Contact your senators and representative now, and tell them to reject this ill-conceived plan.

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Nov 16, 2018
The AMA House of Delegates took unanimous action on the issue, reaffirming the Association’s age-old commitment to equity, fairness and respect.