LEGISLATIVE ALERT #08-04
March 28, 2008
The Issue: Amending Title XVIII of the Social Security Act to postpone the scheduled reduction in the Medicare and TRICARE physician payment rates set to occur July 1, 2008.
Immediate Action Required: Contact your Senators and urge them to support S 2785 which would amend Section 1848(d) of the Social Security Act by postponing for 18 months the scheduled 10.6 % reduction in the rates paid to Medicare and TRICARE physicians that would otherwise take effect July 1, 2008 and the 5% reduction that would take effect January 1, 2009.
Payment rates in the TRICARE program are tied to Medicare rates. To control the growth in Medicare payments to physicians, a complicated programmed formula, designed to keep Medicare payments to physicians in line with a targeted Sustainable Growth Rate (SGR), will reduce Medicare/TRICARE physician payment rates 10.6 percent on July 1, 2008 and another 5 percent on January 1, 2009.
Medicare rules require an annual review and updating of physician fee schedules with the process weighing a number of medical cost factors. In order to achieve budget neutrality and stay within annual targeted SGR, physician fee schedules will either decrease if Medicare spending exceeds the targeted growth figure or increase if Medicare expenses are less than the targeted growth. In an era of rapidly rising medical costs, the annual review would have resulted in a decrease in the physician fee schedules during the last few years had Congress not taken action in its past sessions to postpone the reductions. That is what S 2785 seeks to do with the hope that the 18 month moratorium will allow Congress to fix the Medicare physician payment system rather than apply an annual “band-aid” to a broken Medicare program.
An American Medical Association (AMA) survey has shown that 60 percent of physicians would have to limit the number of Medicare patients they would be willing to treat if the planned reduction in rates were to take effect. The scheduled reduction in physician payment rates has already discouraged physicians form accepting new TRICARE patients. This situation will only deteriorate, leaving many of our TRICARE beneficiaries vainly searching for participating physicians, if Congress does not take action to postpone the reductions. To avoid the reduction in physician rates and retain beneficiary access, Congress has taken action annually to postpone the programmed reductions.
NGAUS and other military support organizations fought hard for years for the enactment of the TRICARE Reserve Select (TRS) program which can potentially cover all members of the Guard and Reserve and their families. Since the October 1, 2007 start of TRS, 65,591 beneficiaries are now covered under TRS with that number sure to increase. Moreover, under the TRICARE for Life program, TRICARE is the second payer to Medicare for a growing population of military retirees.
For the TRICARE benefit to remain meaningful to members of the Guard and their families and to our retirees, Congress must postpone the SGR formula-driven reductions scheduled to occur and craft a solution to Medicare and TRICARE that would encourage robust physician participation.
S 2785 contains additional language that proposes an increase of 1.8 percent in physician payment rates for 2009. NGAUS is not convinced that this increase of 1.8 percent contributes significantly to solving the physician payment issue. It could even dissuade some members of Congress from supporting the bill.
Contact your Senators and ask that they support the “postponement” solution contained in S 2785. Contact your member of the House of Representatives and ask that he/she seek similar legislation in the House.
TAKE THE FOLLOWING ACTION:
By using the “Write to Congress” feature on the NGAUS Web site at www.ngaus.org, you can IMMEDIATELY e-mail your elected representatives. A sample letter is included in our “Write to Congress” feature. You can e-mail the pre-written message or edit the sample letter as you desire. This is the quickest and most effective method of expressing your views to Congress. Also, contact your friends and family and urge them to use Write to Congress as well. For further information and background visit our web site at www.ngaus.org. Please direct any questions concerning this issue to Pete Duffy, NGAUS Deputy Legislative Director at 202-454-5307 or via email at pete.duffy@ngaus.org.
LEGISLATIVE ALERT #08-03
March 28, 2008
The Issue: C-17 Aircraft Funding
Immediate Action Required: Contact your Members of Congress and urge them to support critical C-17 funding in the FY09 Defense Bill
One of the many challenges facing the Department of Defense this year is the impeding closure of the C-17 Globemaster III line. This is the last remaining strategic airlift aircraft being produced in the United States. The Fiscal Year 2009 Air Force budget does not include funding for procurement of additional C-17s to keep the production line open. Current orders will carry the production line to August 2009, beginning shutdown of the supplier base this year.
While the Department of Defense did not include C-17 funding in its budget submission, it does appear on the Air Force’s Unfunded Requirements (UFR) List. America’s airlift requirements are growing and the termination of aircraft production is not consistent with the Nation’s mobility needs. The Army and the Marines have grown by almost 100,000; the Army’s Future Combat System (FCS) is now being predicted not likely to fit onto the C-130 nor will the mine resistant ambush-protected vehicles (MRAP); and the new Africa Command (AFRICOM) has stood up and is an incredibly mobility intense operation in a very large Area of Responsibility (AOR). These three factors prove the requirement for increased mobility aircraft above the 300 set in the 2005 Mobility Capabilities Study. Among these factors, consideration should be given to the fact that each month C-17 transport helps to take approximately 3,500 convoys and nearly 10,000 troops off the roads, avoiding snipers, insurgents, and improvised explosive devices (IEDs).
At an Air Force budget hearing this year Air Force Chief of Staff General Michael Moseley stated that the reasoning for the C-17’s not being in the DoD budget for FY09 is “simply an affordability issue.” The UFR list shows where the Air Force would spend the next dollar if they had another dollar. The reasoning for not including funds in the President’s budget was not based on need or capability it was based on affordability.
Procuring additional C-17 aircraft is critical to the future of our military. Air National Guard wings in several states need to replace retiring mobility aircraft while other states are yet unsure of their follow-on flying mission following the 2005 Base Realignment and Closure decisions. Without procuring additional planes now, the future of these Air National wings and the capability of our military as a whole will deteriorate.
Your help is instrumental in this legislative decision. Contact your members of Congress and urge them to support funding of the C-17 in the FY09 Defense Bill.
TAKE THE FOLLOWING ACTION:
By using the “Write to Congress” feature on the NGAUS Web site at www.ngaus.org, you can IMMEDIATELY e-mail your elected representatives. A sample letter is included in our “Write to Congress” feature. You can e-mail the pre-written message or edit the sample letter as you desire. This is the quickest and most effective method of expressing your views to Congress. Also, contact your friends and family and urge them to "Write to Congress" as well. For more in-depth information and background visit our web site at www.ngaus.org. Please direct any questions concerning this issue to Emily Breitbach, NGAUS Air Programs Manager at 202-408-5893 or via email: emily.breitbach@ngaus.org.