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4-3-15 ENT Advocate

April 3, 2015

Lead Story:
SGR Repeal Bill Awaiting Consideration in U.S. Senate
On March 26, the U.S. House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a broad legislative package that addresses two of the AAO-HNS’ top federal legislative priorities—permanent repeal of the Medicare Sustainable Growth Rate (SGR) physician payment formula and rescinding the new CMS policy to transition all 10- and 90-day global payment codes to 0-day codes by 2018. The 392-37 vote was a rare display of bipartisanship for Capitol Hill, and the U.S. Senate is expected to vote on the measure in mid-April following a two-week recess.

AAO-HNS members are reminded that the scheduled 21 percent payment cut technically went into effect on April 1. However, CMS is temporarily holding claims as it awaits Senate action. For the latest updates on this issue, follow us on Twitter @AAOHNSGovtAffrs or visit the AAO-HNS Legislative and Political Affairs webpage.

Action Requested:
ENT PAC – Your Dedicated Voice on Capitol Hill
It may have taken 14 years, but the physician community is—hopefully—only weeks away from erasing “SGR” from our list of legislative priorities and adding it to our list of victories. As the SGR battles dragged on, ENT PAC has been the specialty’s constant voice on Capitol Hill, forming strong relationships with many of the lawmakers who negotiated the final legislative package to repeal the SGR formula. Those are your dollars at work! Help ensure we are able to keep this momentum going by becoming a 2015 ENT PAC Investor. Log-on to using your AAO-HNS member ID and password (not your email address) to make a contribution online, or send your personal check (payable to ENT PAC) to 1650 Diagonal Road, Alexandria, VA 22314.*

Legislative Action Alert - Tell the Senate to Pass SGR Repeal Bill!
In the weeks leading up to the House vote to repeal the SGR formula, AAO-HNS members delivered more than 1,000 emails to Capitol Hill. Thank you for your support in urging Congress to finally address this critical issue. However, the job is not yet done! Contact your U.S. Senators and tell them to immediately pass H.R. 2 when they return to Capitol Hill!

SGR in the News? Check Your Local Papers
The effort to repeal the SGR formula has been a top news story over the last several weeks. Have you seen any articles in your local papers? Help shape the conversation by writing a letter to the editor today! Contact the Government Affairs team for details at

Informational Updates:
AAO-HNS Supports SGR Repeal Legislation
On March 25, the AAO-HNS sent a letter to the U.S. House of Representatives in support of H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA). The bill incorporates the bipartisan and bicameral legislation that was crafted in the 113th Congress to permanently repeal the flawed SGR formula used to determine payments to physicians under the Medicare program. After 14 years and 17 short-term patches, H.R. 2 will provide much-needed stability for physicians and their patients.

AAO-HNS Urges Senate to Pass SGR Legislation before Recess
On March 26, the AAO-HNS sent a letter to the U.S. Senate expressing support for H.R. 2 and urging lawmakers to pass the bill before recessing for a two-week period. Although CMS has the ability to temporarily hold the processing of payments, the delay continues a pattern of uncertainty for physicians and their patients in the Medicare program.

Academy Issues Press Statements Regarding SGR Legislation
On March 26, the AAO-HNS issued a press statement applauding the U.S. House of Representatives for passing legislation to permanently repeal the SGR. On March 27, the AAO-HNS distributed an additional press statement urging the U.S. Senate to move swiftly to pass H.R. 2 upon its return to Capitol Hill in mid-April.

From the Health Policy Team:
Important Notice: CMS Billing and Medicare
As noted above, the current SGR payment patch expired on April 1. This means that physician services provided on or after April 1 will be subject to a 21 percent cut. The AMA is encouraging physicians to either: 1) continue billing the current 2015 rates (i.e. do not take the 21 percent cut into consideration); or 2) defer submitting claims until final action on the legislation has occurred. Learn more.

Superior Agrees to Change Allergy Policy
The AAO-HNS is pleased to announce that Superior HealthPlan, the largest Medicaid carrier in Texas, has agreed to auto-credential all board-certified and board-eligible otolaryngologist – head and neck surgeons to perform allergy testing and immunotherapy services. 

*Contributions to ENT PAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of the American Academy of Otolaryngology-Head and Neck Surgery have the right to refuse to contribute without reprisal. Federal law prohibits ENT PAC from accepting contributions from foreign nationals. By law, if your contributions are made using a personal check or credit card, ENT PAC may use your contribution only to support candidates in federal elections. All corporate contributions to ENT PAC will be used for educational and administrative fees of ENT PAC, and other activities permissible under federal law. Federal law requires ENT PAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year.