Washington—The American Academy of Ophthalmology today praised the introduction of “The Medicare Physician Payment Reform and Quality Improvement Act of 2006,” calling it an important step toward a fair Medicare reimbursement system and continued access to care for patients. 

If passed into law, the legislation would immediately derail a 4.7 percent cut in physician Medicare reimbursement in 2007, and a 37 percent cut during the next nine years as a result of the Sustainable Growth Rate (SGR) formula, which Medicare uses to calculate physician reimbursement and is tied to growth in the gross domestic product. 

The SGR is responsible for the dramatic cuts in physician Medicare reimbursements during the last five years, and the medical community has been working with Congress to replace it with something more equitable.

The Academy, along with the AMA and other healthcare provider organizations, has provided input to bill sponsor Rep. Michael Burgess, R-Texas, on this important legislation that includes a long-term solution to the SGR debacle. 

“Putting a halt to the cuts and fixing the SGR problem remain the Academy’s highest priorities,” said Catherine G. Cohen, Academy vice president for governmental affairs. “We appreciate the thought that went into Rep. Burgess’s bill and the use of a methodology based on the Medicare Economic Index (MEI), which reflects the true costs of practicing medicine. Tying the SGR to the MEI is something the Academy has been fighting for during the last five years.”

Instead of the SGR, the Burgess Bill calls for a quality improvement program under Medicare, a concept that the Academy and other specialties have been working on with Congress, the Centers for Medicare and Medicaid Services (CMS) and others. 

The bill outlines a voluntary physician reporting system that would be developed in collaboration with specialty organizations.

Additionally, the bill calls for the reinstatement of balanced billing, allowing physicians who do not accept Medicare to bill more than 115 percent of normal charges. The bill would also strengthen and modernize the Quality Improvement Organization (QIO) and increase accountability.

“We support Rep. Burgess’s efforts to solve the long-term SGR problem and his insistence on physician leadership in the development of quality measures,” said Cohen. “With the end of this session of Congress on the horizon, we need to act quickly to ensure a fair update for physicians.”