ASTRO praises bipartisan Congress and President for timely and historic passage of legislation to permanently fix SGR
The American Society for Radiation Oncology (ASTRO) applauds the House of Representatives, the Senate and the President for milestone passage last night of the “Medicare Access and CHIP Reauthorization Act” (H.R. 2) that permanently repeals the sustainable growth rate (SGR) formula, which has plagued the nation’s health care infrastructure for more than a decade.
The SGR, originally enacted as part of the Balanced Budget Act of 1997, has been patched 17 times in the years since then, and a 21.2 percent rate reduction for all physicians was scheduled to take effect on April 15, 2015. The House of Representative passed H.R. 2 on April 2, 2015 with an overwhelming vote of 392—37. Last night, the Senate approved the bill with a 92—8 vote, and President Obama formally enacted H.R. 2 with his signature.
“Repealing the SGR has been an ASTRO priority for years, and passage of this legislation represents a long-awaited, historic victory for our patients. Permanently repealing the SGR and replacing it with a stabilized reimbursement plan focused on quality will strengthen Medicare and allow us to enhance cancer care for the more than one million patients treated with radiation therapy each year,” said Bruce G. Haffty, MD, FASTRO, Chair of ASTRO’s Board of Directors. “We commend the strong bipartisan leadership in the House and Senate, and President Obama for this extraordinary achievement that will ensure that patients have access to the care that they need. We are excited to turn the page on the SGR and to work with Congress and the President on additional needed Medicare reforms, including stabilizing specific radiation oncology payments and protecting patients and the integrity of the Medicare program by closing the physician self-referral loophole.”
H.R. 2 will increase physician pay by 0.5 percent in the second half of 2015, and then an additional 0.5 percent annually from 2016 through the end of 2019; the 2019 rates would be maintained through 2025 with no additional increases. The bill also includes comprehensive structural changes to Medicare’s reimbursement model that will promote physician participation in clinical quality improvement activities and value-based, quality care that will take full effect in 2019. In addition, current Medicare programs that reward electronic health records, quality reporting, the value-based modifier and meaningful use will be merged by 2019 to encourage participation and to reduce the administrative burden. The Children’s Health Insurance Program also received funding for two more years, and $7.2 billion was allocated for community health centers.
ASTRO will continue working to achieve its other Medicare priorities, including stabilizing payments specific to radiation oncology, which have faced a series of payment cuts under the Medicare physician fee schedule in recent years. In addition, ASTRO will prioritize closing the self-referral law’s in-office ancillary services exception for radiation oncology. This loophole has consistently been shown to lead to overutilization and inappropriate care among radiation therapy and other services. Closing the loophole is evidence-based policy supported by President Obama, numerous bipartisan groups, AARP and others and would save Medicare $3.5 billion over 10 years, according to the Congressional Budget Office.
ASTRO is the premier radiation oncology society in the world, with nearly 11,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals that specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes two medical journals, International Journal of Radiation Oncology • Biology • Physics (www.redjournal.org) and Practical Radiation Oncology (www.practicalradonc.org); developed and maintains an extensive patient website, www.rtanswers.org; and created the Radiation Oncology Institute (www.roinstitute.org), a non-profit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visit www.astro.org.