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    December 13, 2017
     
    The Honorable Mitch McConnell
    Majority Leader
    United States Senate
    Washington, D.C. 20510
    The Honorable Paul D. Ryan
    Speaker of the House of Representatives
    United States House of Representatives
    Washington, D.C. 20515
    The Honorable Charles E. Schumer
    Democratic Leader
    United States Senate
    Washington, D.C. 20510
    The Honorable Nancy Pelosi
    Democratic Leader
    United States House of Representatives
    Washington, D.C. 20515


    Dear Leaders McConnell and Schumer, Speaker Ryan, and Leader Pelosi:

    As Congress considers the Tax Cuts and Jobs Act (H.R. 1) and end-of-year budget legislation, the Medical Group Management Association (MGMA) writes to oppose the use of sequestration as a backstop funding source. MGMA has opposed sequestration and its perpetual 2% reduction to Medicare payments since its inception in the Budget Control Act of 2011. This irresponsible policy should be repealed outright and Congress should reject any attempts to expand its use.

    MGMA represents more than 40,000 medical practice administrators, executives, and leaders in 12,500 organizations of all sizes, types, structures and specialties that collectively deliver nearly half of all healthcare in the United States.

    Under the 2010 Pay-As-You-Go (PAYGO) Act, any law that is not budget neutral will trigger automatic cuts to mandatory spending programs through budget sequestration. According to an analysis1 by the Congressional Budget Office, H.R. 1’s $1.5 trillion price tag could double the current sequestration cuts to Medicare payments from 2% to 4%, which would remove $25 billion from Medicare payments in 2018 alone.

    Sequestration and its 2% reduction on Medicare payments has been extended three separate times to offset costs for new legislation and prolonged to 2025. Medical practices should not be punished for accepting Medicare patients by having their payments repeatedly slashed. Congress should reject any attempts to expand this policy, prevent additional cuts from being triggered, and work in a responsible manner to repeal sequestration altogether.

    Physicians are in the midst of a major payment shift within Medicare, from a system based on volume of services rendered to one that emphasizes value and keeping patients healthy. For this transition to work effectively, physician practices need stability.

    We urge Congress in the strongest possible terms to find responsible funding mechanisms for its policies and avert additional threats to Medicare payments.

    Sincerely,
    Halee Fischer-Wright, MD, MMM, FAAP, CMPE
    President and CEO

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