Eyeworld

November 2011 G rassroots efforts, such as the summertime Alliance of Specialty Medicine Fly- In, which encouraged doctors to interact and visit with members of Congress and press those lawmakers for healthcare changes, continue to push for a per- manent fix to Medicare's sustainable growth rate (SGR). In July, the Alliance of Specialty Medicine, including 14 members from the American Society of Cataract & Refractive Surgery, visited Washington, D.C., to hear from Re- publicans and Democrats about their views on healthcare initiatives. Since then, legislation was en- acted that appointed the Joint Select Committee on Deficit Reduction, which is responsible for recom- mending by Nov. 23 a minimum of $1.2 trillion in additional cuts over a 10-year period. The committee, which was ap- pointed in August, is made up of 12 members of Congress—six Republi- cans and six Democrats, three from the House and three from the Sen- ate. The physician community has turned its focus toward the Joint Deficit Committee with the request that the SGR be repealed because the committee can include entitlement reforms in its proposal, according to ASCRS Government Relations Direc- tor Nancey K. McCann. "We believe that it is a deficit. It's the Medicare deficit as they are moving toward new payment mod- els. If they don't deal with the SGR in this proposal, there will be very little chance of dealing with it in the future because all of the offsets will be used for other things," Ms. McCann said. Congress needs to vote on the committee's recommendations by a simple majority vote by Dec. 23. Physician reimbursements from Medicare have stayed static for the past decade, and a deep cut of nearly 30% is scheduled to take effect on Jan. 1 if Congress doesn't act. Previ- ously, Congress has used several short-term fixes to prevent cuts. This time, however, a real fix seems to be part of the discussion, Ms. McCann said. "It's really on the table, and one of the reasons is because the medical community has been ramping up its grassroots efforts," Ms. McCann said. "ASCRS, the Alliance, the American Medical Association, and other medical groups have been doing it. The message has been uni- fied that the Joint Deficit Commit- tee must repeal the SGR now. This is the opportunity." Lawmakers seem to listen when doctors take the time to come to Washington, meet with their mem- bers of Congress, and make it clear to them the SGR has to be repealed. "We cannot go down this road any longer," Ms. McCann said. "We cannot dig ourselves into a bigger hole. Congress has put off fixing the problem and has created this deficit." Ms. McCann said that there were discussions about another last- minute, temporary reprieve, which would be 2 years with a small posi- tive update and cliff financing, should Congress fail to act. "The reduction after 2 years would be 40%," she said. "We have made it clear that is not acceptable. ASCRS has never supported short- term fixes that exacerbate the cost of fixing the problem and the magni- tude of the cuts." The Medicare Payment Advisory Commission (MedPAC) came out with its recommendations on how to deal with the SGR in October. The commission approved a 10-year Medicare reform plan that would re- peal the SGR and reduce reimburse- ments to specialists by 5.9% per year for 3 years and then freeze them for 7, while primary care provider reim- bursement rates would freeze for the entire 10. The Alliance immediately sent out a press release blasting the plan because of the negative way it im- pacted specialists. "It fell with a thud in Con- gress," Ms. McCann said. "It was not acceptable to key committees with jurisdiction over Medicare, and it wasn't favorably received on Capitol Hill." Most recently, during the com- mittee's first public policy hearing, the idea of counting savings from the upcoming troop withdrawals as deficit reduction and using that money to support a full repeal of the SGR formula was discussed. The Alliance is also continuing to push for the repeal of the contro- versial Independent Payment Advi- sory Board (IPAB), a group of 15 peo- ple appointed by the President that would be responsible for recom- mending payment policies for Medicare. The board would make recommendations for cuts to physi- cians' Medicare reimbursements, and those proposals would be hard to overturn because they could only be blocked by a 60-vote super major- ity vote in the Senate. It has also asked the committee to consider private contracting and medical liability reform, the latter of which, according to Ms. McCann, could save the system $50 billion. "We have been told that the only issue that is on the table right now is the SGR repeal," she said. The next Alliance Fly-In is sched- uled for June 2012. ASCRS members should contact Ms. McCann if they would like to attend. ASCRS members can contact their members of Congress today by logging on to www.ascrsgrassroots. org, clicking "Take Action," and then clicking "Contact Your Rep Today." Make sure all of the required personal information is complete, then write a brief introduction and closing to your member of Congress before sending the message. EW Editors' note: Ms. McCann has no financial interests related to this article. Contact information McCann: nmccann@ascrs.org EW NEWS & OPINION 3 Grassroots efforts are one reason why SGR may be headed toward repeal by Jena Passut EyeWorld Staff Writer Fly-In participants traveled to Washington, D.C., in July to learn about healthcare initiatives and press lawmakers for changes Sandra W. Yeh, M.D., speaks at the Alliance of Specialty Medicine Fly-In

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