Medicare Updates for PHers

Goodbye SGR, Hello New Medicare Cards

On April 16, 2015, the Medicare Access and CHIP Reauthorization Act (H.R. 2) was signed into effect by President Barack Obama after a bipartisan effort in both the House and Senate. Here are some notable results:

1. SGR Repeal
   The Medicare Sustainable Growth Rate, or SGR, is an outdated payment formula that has been in place since the '90s. Historically, it has reduced payments to Medicare physicians and threatened patients' access to treatment. H.R. 2 will replace this flawed formula with modest annual increases to Medicare funding.
    
2. Upgraded Medicare Cards
   Medicare will finally upgrade its Medicare cards to remove beneficiaries’ Social Security numbers from their cards. Many, including the Social Security Administration, have long protested this practice, noting the potential for identify theft. In this bill, Congress allocates $320 million over four years to fund the transition.
    
3. Higher Quality Care
   The bill includes a provision that incentivizes a transition from volume-based payments to value-based payments. This will encourage physicians to provide PH patients on Medicare with more consistent quality care at reasonable costs.

PHA has long lobbied for Medicare reform to address these needs and ensure treatment access for PH patients. Moving forward, PHA hopes to target the high out-of-pocket costs of specialty PH medications with the Patients' Access to Treatments Act (H.R. 1600).

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Advocacy Success - National PH Call-In Day

April 16, 2015, was also PHA’s National Call-In Day, a day-long event where PH community members called their Members of Congress and asked them to co-sponsor the Patients’ Access to Treatments Act. Constituents from 17 reported states made the calls and, within a week, eight legislators co-sponsored the bill, bringing the total to 66 co-sponsors.

To help PHA move this legislation through Congress and reduce the excessive out-of-pocket costs of PH medications, please visit PHA's Advocacy Action Center.