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Blog: Focusing On Doc Fix


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Congress is fast approaching the expiration of the current Doc-Fix legislation. The disbanding of the Supercommittee means that Congress has until the end of December to pass a new Doc-Fix act. Without a new Doc-Fix, physicians are forced to take a payment cut of 27.4% for services rendered to Medicare patients. How much Medicare should pay physicians is determined by the Sustainable Growth Rate Formula, or SGR. Enacted by the Balanced Budget Act of 1997, the SGR takes into account estimated percentage change in fees for physicians' services, percentage change in the average number of Medicare fee-for-service beneficiaries, 10-year average annual percentage change in real GDP per capita and any estimated changes due to new laws and regulations.

The problem with the formula is that it always ends up predicting that Medicare will cost less than it actually does, and Congress has to make adjustments annually to avoid payment cuts to Medicare providers. Sure, Congress may find the money, but it leaves the American people wondering when Washington will learn from its mistakes and start focusing on the root of the problem. Balancing the SGR formula is a 300 billion dollar distraction at a time when the people are looking for long-term decisions. Congress needs united dedication to permanently fixing the SGR and ensuring the protection of both our seniors' healthcare and the physicians who provide medical treatment for them.

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