Last-minute ‘Fiscal Cliff’ Deal by Congress Again Averts Medicare Cuts to Physicians

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This end-of-year crisis management once again demonstrates the critical need for fundamental reform of the Medicare reimbursement system.

—Clifford A. Hudis, MD

A last-minute patch to the sustainable growth rate formula included in the “fiscal cliff” deal averted massive cuts to oncologists who care for and treat Medicare patients. “This end-of-year crisis management once again demonstrates the critical need for fundamental reform of the Medicare reimbursement system,” commented ASCO President-Elect Clifford A. Hudis, MD, in a statement after the deal was achieved.

“ASCO is pleased the legislation includes a provision that allows physicians to satisfy federal quality reporting requirements through clinical data registries approved by the U.S. Department of Health and Human Services (HHS),” Dr. Hudis continued. “By allowing these as an alternative to quality reporting currently required by the Centers for Medicare and Medicaid Services, Congress has taken a critical first step towards a more robust quality monitoring system in cancer,” he said.

“ASCO worked to achieve bipartisan support for this provision, which begins in 2014, and will continue to work in 2013 with the HHS Secretary and the Administration to ensure ASCO’s Quality Oncology Practice Initiative® (QOPI) can be used to fulfill the quality reporting requirements,” said Dr. Hudis.

“Unfortunately, the triple-threat of sequestration cuts to cancer research, physician reimbursement, and drug review oversight—jeopardizing oncologists’ ability to care for their patients—is only temporarily averted, with the new 113th Congress having just 2 months to resolve the mandatory spending cuts. ASCO will continue to advocate for the protection of critical funding to the National Cancer Institute, Medicare, and the Food and Drug Administration,” he added.

Dr. Hudis concluded, “ASCO is pleased cancer patients and their doctors have a momentary reprieve from political brinksmanship, but the new year will continue to bring major policy challenges. ASCO stands ready to work with Congress, the Administration, and the medical community to ensure that the nearly 1.6 million individuals who will receive a cancer diagnosis this year have access to high-quality, high-value care and services.”

AMA Statement

“Congress averted a drastic cut of 26.5% from hitting physicians who care for Medicare patients on January 1,” stated American Medical Association President Jeremy A. Lazarus, MD. “This patch temporarily alleviates the problem, but Congress’ work is not complete; it has simply delayed this massive, unsustainable cut for 1 year. Over the next months, it must act to eliminate this ongoing problem once and for all,” he said.

“This last-minute action on the part of Congress is a clear example of how the Medicare program is increasingly unreliable for physicians and patients,” Dr. Lazarus added. “This instability stalls progress in moving Medicare toward new health-care delivery models that can improve value for patients through better care coordination. Physicians want to work with Congress to move past this ongoing crisis and toward a Medicare program that ensures access to care and the best health outcomes for patients and a stable, rewarding practice environment for physicians.”

ASH Statement

A statement issued by the American Society of Hematology (ASH) on the deal noted that the Society was pleased about immediate protection for biomedical research and physician reimbursement, but urged Congress to protect programs from further cuts and the “next cliff.”

“While the legislation passed protects the country from going over a fiscal cliff for the time being, the Society is keenly aware that NIH and other nondefense discretionary programs are not safeguarded from future cuts, and there is not a permanent solution for the flawed physician payment formula,” the statement read.

“Given this uncertain outlook, ASH will continue to urge lawmakers to provide balanced deficit reduction that does not further cut discretionary programs like NIH. The Society will educate Congress about the value of biomedical research so that all members of the new 113th Congress understand that this is not the time to defund science and that discoveries made possible by investments in NIH generate incredible returns in the form of lives and jobs and importantly help secure America’s position as a global economic force.” ■