Medicare payment reform bill advances in U.S. House

At the urging of the AOA and other physician groups, all fifty-one members of the U.S. House Committee on Energy and Commerce voted today, with bi-partisan unanimity, to approve a plan to repeal the flawed sustainable growth rate (SGR) payment system under Medicare. The approved legislation would replace SGR with a quality care-based program to provide stable payments to doctors and other providers.

The AOA played a positive role in making Medicare payment stability a top priority for Congress.

The SGR formula is the faulty mechanism under Medicare that requires short-term "patches" by Congress each year to avert massive cuts in payments to providers. The Congressional Budget Office estimates the cost of repealing the current payment formula at $139.1 billion over 10 years.

The legislation the committee approved today seeks to establish a five-year transition period while new quality care and performance incentives are developed. During this time, payments to doctors and other providers would increase by 0.5 percent per year. In 2019, ODs, MDs and other providers would be eligible for a 1 percent increase in rates on top of the inflationary raise if they meet approved care benchmarks. 

Advocacy efforts continue

Through grassroots and direct Capitol Hill lobbying efforts, the AOA played a positive role in making Medicare payment stability a top priority for Congress this year. The AOA also worked to shape provisions directly affecting physician participation and payment.

Even before an initial draft of the bill was released in late May, the AOA was participating in Capitol Hill discussions aimed at ensuring that ODs would be fully eligible for physician payment updates and incentives.

Key members of the Energy and Commerce Subcommittee on Health, including Reps. Joe Pitts (R-PA), Michael Burgess (R-TX) and Jan Schakowsky (D-IL), as well as full committee member Bruce Braley (D-IA), have kept an open door for optometry in continuing discussions about the bill.

Optometry also has weighed in with the Senate Finance Committee, which is preparing its own draft bill on Medicare payment reform. Senator Orrin Hatch (R-UT), the committee's ranking Republican, told AOA staff at a recent meeting that he wants to ensure ODs and their patients are treated fairly under any new system.

How to get involved

Federal Keyperson doctors are continuing their outreach with U.S. Senators and House members during the August Congressional recess to discuss the essential role optometrists play as physicians in Medicare. 

The 2013 AOA Congressional Advocacy Conference, to be held September 9-11 in Washington, D.C., presents a timely opportunity for those who want to join the push for reform. AOA doctors and students will have the chance to participate in Capitol Hill meetings on this critical issue as part of the conference.

For more information, contact Jon Hymes, director of the AOA Washington Office, at 1-800-365-2219 or

July 31, 2013

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