Please Ask Your Representative to Support HR 3617 Today!

Legislation has been introduced that will abolish the un-sustainable Sustainable Growth Rate (SGR) formula and replace it with the Medicare Economic Index (MEI). A very encouraging and helpful bill was introduced by House Ways and Means Subcommittee on Health Chair Nancy Johnson (R-CT) to give physicians relief from the damaging effect of the SGR cuts. The legislation, the Medicare Value-Based Purchasing for Physicians' Services Act of 2005, H.R. 3617, will provide real reform to the way physicians are paid for their services in Medicare and give urologists the opportunity to receive the compensation they deserve for their high quality of service.

H.R. 3617 includes several important features that have won the support of several physician groups. First, Mrs. Johnson's bill would eliminate the negative update that is slated for 2006 and provide for a positive increase of 1.5 percent. More importantly, beginning in 2007 the bill will eliminate the flawed Medicare SGR formula, and if physicians submit quality and efficiency (Q&E) data to the Centers for Medicare & Medicaid Services (CMS), payment would be based on the MEI. For physicians who do not report data, their update would be MEI minus one percent.

The House Q&E measures would include a mixture of outcome, process and structural measures; would be developed specifically by the relevant physician specialty organizations; evidence-based; and would be consistent, validated, practicable and not overly burdensome to collect. Additionally, the phase in time for implementation is more gradual and requires pilot testing of measures. This legislation will require public reporting on benchmarked outcomes based on these measures. The final design of the public benchmarking has not yet been determined and the AUA will work to ensure that such information will be protected from unreasonable liability claims and that physicians are benchmarked in a fair and appropriate manner.

This legislation is currently the best attempt at trying to create an appropriate system for physician pay-for-performance and meets a majority of the principles approved by the AUA Board of Directors. The AUA has worked hard to express the concerns of urologists to Rep. Johnson and so far she has been very receptive to our suggestions. The whole federal government is moving towards value-based purchasing or pay-for-performance and this legislation is the best opportunity to shape this policy before CMS imposes it without physician input.

The AUA needs to get support for H.R. 3617. This is the case of a member of Congress consulting and accepting our recommendations and now she needs our support. Given the current climate with the Administration and the U.S. Senate showing little interest in permanently fixing the SGR, urologists need to support legislation that scraps the current flawed Medicare physician payment update system. This has been one of the AUA's top legislative priorities for the last five years and the time to act is now.

Please log onto the AUA advocacy site at http://www.auanet.org/takeaction/ and take action today.