Sessions Introduces Physician Payment Legislation

Press Release

Sessions Introduces Physician Payment Legislation

U.S. Congressman Pete Sessions (R-Dallas) has introduced the Medicare Physician Payment Reform Act of 2007 (H.R.3038), which will provide a long-term solution to the serious Medicare payment reductions that many physicians are facing.

Unless Congress acts, the 2008 Medicare physician payment rates are scheduled for a nearly 10 percent reduction - an amount that could total 40 percent in the next decade (2007 Medicare Trustees Report). These reductions come as a result of the sustainable growth rate (SGR), which sets a single target based on growth domestic product (GDP) for allowable growth in Medicare spending on all physician services.

The Medicare Physician Payment Reform Act (MPPRA) recognizes the unique nature of various physician services by replacing the current antiquated, universal payment system with a new payment system - the Service Category Growth Rate (SCGR). The SCGR would set separate payment formulas for the following seven physician services:

* Evaluation and management (E&M)
* Radiology services and diagnostic tests
* Major procedures (includes those with 10- or 90-day global service periods) and related anesthesia services
* Anesthesia services paid on the separate anesthesia fee schedule
* Minor procedures and all other services not paid under physician fee schedule
* Diagnostic laboratory tests
* Physician-administered Part B drugs, biologicals, and radiopharmaceuticals

Under current law, if the total Medicare payments to physicians exceed the SGR targets in a year, then the program must offset those payments by reducing the payment formula in future years. In contrast, the MPPRA would provide a statutory specified allowance in expenditure growth and would bring greater stability to Medicare's physician payment structure.

"Physicians serve as the foundation for the Medicare program, and Congress has the responsibility to ensure Medicare's successful healthcare alliance is not undermined through the current unpredictable and punitive physician payment system," Congressman Sessions stated. "My legislation provides a fair and lasting solution for Medicare payments that meets the unique needs of a 21st century health care system."

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