Alicia Ault

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR's spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners' interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers' time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there's a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We're in a deteriorating situation here; we're spiraling down," said Mr. Hackbarth. "This isn't going to get better; it's going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians' confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR's spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners' interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers' time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there's a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We're in a deteriorating situation here; we're spiraling down," said Mr. Hackbarth. "This isn't going to get better; it's going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians' confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR's spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners' interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers' time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there's a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We're in a deteriorating situation here; we're spiraling down," said Mr. Hackbarth. "This isn't going to get better; it's going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians' confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

WASHINGTON – Multiple options exist to permanently fix the Medicare Sustainable Growth Rate formula, but each has its cost to physicians, patients, and the program, according to staff analysts for the Medicare Payment Advisory Commission.

Among the options MedPAC staff presented to commissioners at their Feb. 23 meeting were adjusting the SGR’s spending targets so that they are no longer cumulative, but are calculated on an annual basis and allowing some flexibility in the target. Both of those options would forgive any excess over the target, removing the annual pay cut threat doctors have endured since 2002 under the SGR, according to Cristina Boccuti, a principal policy analyst for MedPAC. However, forgiving any overage will lead to higher costs for the Medicare program. Neither option would leave any room to offer incentives for improved quality and efficiency, she added.

In the past, MedPAC has recommended setting target growth rates – and payment rates – according to particular service categories; the commission is looking in this direction again. For example, separate categories could be established for primary care, imaging, minor procedures, and anesthesia, allowing rates to more closely track volume of services. But the system might also provide incentives for physicians to order higher-volume (and more highly paid) services, according to Kevin Hayes, another MedPAC principal policy analyst.

Two options that seemed to pique commissioners’ interest: exempting certain providers (such as accountable care organizations) from the current SGR target but holding them accountable for other targets, and using penalties for physicians who are outliers in terms of resource use.

MedPAC currently has two contractors working on projects to better determine the valuation of providers’ time and resource use; more information will be available at the next commission meeting, Ms. Boccuti said.

Every year since 2002, Medicare has failed to meet the SGR targets, causing physician pay, by law, to be reduced. However, pretty much every year, and more recently, two or three times a year, Congress has stepped in to legislate a way to avoid those cuts. Cumulatively, the avoided cuts are becoming an ever-growing debt being carried on the federal ledger.

The White House, in its fiscal 2012 budget proposal, is proposing to reduce that debt over the next 10 years, at a cost of $370 billion.

But the administration has figured out only how to pay for that fix for the first 2 years. The reality is that there’s a declining pool of Medicare-specific offsets – required by law – to pay for fixing the SGR, Glenn Hackbarth, MedPAC chairman, said at the meeting.

"We’re in a deteriorating situation here; we’re spiraling down," said Mr. Hackbarth. "This isn’t going to get better; it’s going to get worse."

Mr. Hackbarth said that he envisions a future where lawmakers will have to take money from education or roads or some other non–health-related area of the budget to pay for the Medicare fix. "And that bothers me," he said.

MedPAC in 2001 saw trouble down the road with the SGR and recommended at that time that it be scrapped. Now, the commission is looking again at ways to overhaul the formula so that physicians do not have to face a constantly shifting landscape. The uncertainty is undermining physicians’ confidence in Medicare and leading some to stop seeing beneficiaries, Mr. Hackbarth noted.

He said that the time might be right to work out a "quid pro quo" with physicians: an end to the yearly exercise to avert the SGR cuts in exchange for a payment system that has volume constraints and rewards efficiency and improved quality, or, alternatively penalizes those who fail to meet such targets.

The House of Representatives voted 240-185 on Feb. 18 to approve an amendment that would strip all federal funding for Planned Parenthood.

The vote was largely along party lines, with the majority of Republicans voting in favor, and the majority of Democrats voting in opposition. Ten Democrats voted for the amendment, while 7 Republicans voted against it.

The amendment will be attached to a larger bill that would fund federal government operations for the current fiscal year, which began Oct. 1. The legislation – called a continuing resolution – that currently funds the government expires March 4. This new CR has to pass the full House, and is expected to do so by Feb. 21. It then must be passed by the Senate.

Planned Parenthood currently is barred from using federal funds to perform abortions, but it receives taxpayer dollars for family planning, contraception, and medical services. Rep. Mike Pence (R-Ind.) sponsored the amendment to bar any federal funds from going to the organization.

In a statement, Rep. Pence said, "This afternoon’s vote is a victory for taxpayers and a victory for life. By banning federal funding to Planned Parenthood, Congress has taken a stand for millions of Americans who believe their tax dollars should not be used to subsidize the largest abortion provider in America."

Planned Parenthood President Cecile Richards issued a response, stating, "In attacking Planned Parenthood, the House Republican leadership has launched an outrageous assault on the millions of Americans who rely on Planned Parenthood for primary and preventive health care, including lifesaving breast and cervical cancer screenings, annual exams, family planning visits, birth control, HIV testing, and more."

The vote also was condemned by Nancy Keenan, president of NARAL Pro-Choice America. "The new anti-choice House leadership promised a jobs agenda and is now waging a war on contraception," she said, in a statement."As the debate goes to the Senate, our members will tell senators that they must put a stop to this extreme anti-choice agenda."

The House of Representatives voted 240-185 on Feb. 18 to approve an amendment that would strip all federal funding for Planned Parenthood.

The vote was largely along party lines, with the majority of Republicans voting in favor, and the majority of Democrats voting in opposition. Ten Democrats voted for the amendment, while 7 Republicans voted against it.

The amendment will be attached to a larger bill that would fund federal government operations for the current fiscal year, which began Oct. 1. The legislation – called a continuing resolution – that currently funds the government expires March 4. This new CR has to pass the full House, and is expected to do so by Feb. 21. It then must be passed by the Senate.

Planned Parenthood currently is barred from using federal funds to perform abortions, but it receives taxpayer dollars for family planning, contraception, and medical services. Rep. Mike Pence (R-Ind.) sponsored the amendment to bar any federal funds from going to the organization.

In a statement, Rep. Pence said, "This afternoon’s vote is a victory for taxpayers and a victory for life. By banning federal funding to Planned Parenthood, Congress has taken a stand for millions of Americans who believe their tax dollars should not be used to subsidize the largest abortion provider in America."

Planned Parenthood President Cecile Richards issued a response, stating, "In attacking Planned Parenthood, the House Republican leadership has launched an outrageous assault on the millions of Americans who rely on Planned Parenthood for primary and preventive health care, including lifesaving breast and cervical cancer screenings, annual exams, family planning visits, birth control, HIV testing, and more."

The vote also was condemned by Nancy Keenan, president of NARAL Pro-Choice America. "The new anti-choice House leadership promised a jobs agenda and is now waging a war on contraception," she said, in a statement."As the debate goes to the Senate, our members will tell senators that they must put a stop to this extreme anti-choice agenda."

The House of Representatives voted 240-185 on Feb. 18 to approve an amendment that would strip all federal funding for Planned Parenthood.

The vote was largely along party lines, with the majority of Republicans voting in favor, and the majority of Democrats voting in opposition. Ten Democrats voted for the amendment, while 7 Republicans voted against it.

The amendment will be attached to a larger bill that would fund federal government operations for the current fiscal year, which began Oct. 1. The legislation – called a continuing resolution – that currently funds the government expires March 4. This new CR has to pass the full House, and is expected to do so by Feb. 21. It then must be passed by the Senate.

Planned Parenthood currently is barred from using federal funds to perform abortions, but it receives taxpayer dollars for family planning, contraception, and medical services. Rep. Mike Pence (R-Ind.) sponsored the amendment to bar any federal funds from going to the organization.

In a statement, Rep. Pence said, "This afternoon’s vote is a victory for taxpayers and a victory for life. By banning federal funding to Planned Parenthood, Congress has taken a stand for millions of Americans who believe their tax dollars should not be used to subsidize the largest abortion provider in America."

Planned Parenthood President Cecile Richards issued a response, stating, "In attacking Planned Parenthood, the House Republican leadership has launched an outrageous assault on the millions of Americans who rely on Planned Parenthood for primary and preventive health care, including lifesaving breast and cervical cancer screenings, annual exams, family planning visits, birth control, HIV testing, and more."

The vote also was condemned by Nancy Keenan, president of NARAL Pro-Choice America. "The new anti-choice House leadership promised a jobs agenda and is now waging a war on contraception," she said, in a statement."As the debate goes to the Senate, our members will tell senators that they must put a stop to this extreme anti-choice agenda."

The House of Representatives voted 240-185 on Feb. 18 to approve an amendment that would strip all federal funding for Planned Parenthood.

The vote was largely along party lines, with the majority of Republicans voting in favor, and the majority of Democrats voting in opposition. Ten Democrats voted for the amendment, while 7 Republicans voted against it.

The amendment will be attached to a larger bill that would fund federal government operations for the current fiscal year, which began Oct. 1. The legislation – called a continuing resolution – that currently funds the government expires March 4. This new CR has to pass the full House, and is expected to do so by Feb. 21. It then must be passed by the Senate.

Planned Parenthood currently is barred from using federal funds to perform abortions, but it receives taxpayer dollars for family planning, contraception, and medical services. Rep. Mike Pence (R-Ind.) sponsored the amendment to bar any federal funds from going to the organization.

In a statement, Rep. Pence said, "This afternoon’s vote is a victory for taxpayers and a victory for life. By banning federal funding to Planned Parenthood, Congress has taken a stand for millions of Americans who believe their tax dollars should not be used to subsidize the largest abortion provider in America."

Planned Parenthood President Cecile Richards issued a response, stating, "In attacking Planned Parenthood, the House Republican leadership has launched an outrageous assault on the millions of Americans who rely on Planned Parenthood for primary and preventive health care, including lifesaving breast and cervical cancer screenings, annual exams, family planning visits, birth control, HIV testing, and more."

The vote also was condemned by Nancy Keenan, president of NARAL Pro-Choice America. "The new anti-choice House leadership promised a jobs agenda and is now waging a war on contraception," she said, in a statement."As the debate goes to the Senate, our members will tell senators that they must put a stop to this extreme anti-choice agenda."

The House of Representatives voted 240-185 on Feb. 18 to approve an amendment that would strip all federal funding for Planned Parenthood.

The vote was largely along party lines, with the majority of Republicans voting in favor, and the majority of Democrats voting in opposition. Ten Democrats voted for the amendment, while 7 Republicans voted against it.

The amendment will be attached to a larger bill that would fund federal government operations for the current fiscal year, which began Oct. 1. The legislation – called a continuing resolution – that currently funds the government expires March 4. This new CR has to pass the full House, and is expected to do so by Feb. 21. It then must be passed by the Senate.

Planned Parenthood currently is barred from using federal funds to perform abortions, but it receives taxpayer dollars for family planning, contraception, and medical services. Rep. Mike Pence (R-Ind.) sponsored the amendment to bar any federal funds from going to the organization.

In a statement, Rep. Pence said, "This afternoon’s vote is a victory for taxpayers and a victory for life. By banning federal funding to Planned Parenthood, Congress has taken a stand for millions of Americans who believe their tax dollars should not be used to subsidize the largest abortion provider in America."

Planned Parenthood President Cecile Richards issued a response, stating, "In attacking Planned Parenthood, the House Republican leadership has launched an outrageous assault on the millions of Americans who rely on Planned Parenthood for primary and preventive health care, including lifesaving breast and cervical cancer screenings, annual exams, family planning visits, birth control, HIV testing, and more."

The vote also was condemned by Nancy Keenan, president of NARAL Pro-Choice America. "The new anti-choice House leadership promised a jobs agenda and is now waging a war on contraception," she said, in a statement."As the debate goes to the Senate, our members will tell senators that they must put a stop to this extreme anti-choice agenda."

The House of Representatives voted 240-185 on Feb. 18 to approve an amendment that would strip all federal funding for Planned Parenthood.

The vote was largely along party lines, with the majority of Republicans voting in favor, and the majority of Democrats voting in opposition. Ten Democrats voted for the amendment, while 7 Republicans voted against it.

The amendment will be attached to a larger bill that would fund federal government operations for the current fiscal year, which began Oct. 1. The legislation – called a continuing resolution – that currently funds the government expires March 4. This new CR has to pass the full House, and is expected to do so by Feb. 21. It then must be passed by the Senate.

Planned Parenthood currently is barred from using federal funds to perform abortions, but it receives taxpayer dollars for family planning, contraception, and medical services. Rep. Mike Pence (R-Ind.) sponsored the amendment to bar any federal funds from going to the organization.

In a statement, Rep. Pence said, "This afternoon’s vote is a victory for taxpayers and a victory for life. By banning federal funding to Planned Parenthood, Congress has taken a stand for millions of Americans who believe their tax dollars should not be used to subsidize the largest abortion provider in America."

Planned Parenthood President Cecile Richards issued a response, stating, "In attacking Planned Parenthood, the House Republican leadership has launched an outrageous assault on the millions of Americans who rely on Planned Parenthood for primary and preventive health care, including lifesaving breast and cervical cancer screenings, annual exams, family planning visits, birth control, HIV testing, and more."

The vote also was condemned by Nancy Keenan, president of NARAL Pro-Choice America. "The new anti-choice House leadership promised a jobs agenda and is now waging a war on contraception," she said, in a statement."As the debate goes to the Senate, our members will tell senators that they must put a stop to this extreme anti-choice agenda."

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.

The White House on Feb. 18 issued a rule that would mostly overturn a regulation that was widely interpreted to allow health care providers to opt out of providing services such as contraception or abortion, or bar federal funding to those entities that did not accommodate providers’ wishes to deny services.

The so-called conscience rule was issued in 2008 at the end of the George W. Bush administration. The new regulation mostly rescinds that rule.

In issuing the new regulation, the Health and Human Services department said that it "supports clear and strong conscience protections for health care providers who are opposed to performing abortions," and that protections that have existed for decades will continue to offer the same coverage.

But, the Bush Administration rule was overbroad and confusing, HHS said in the final rule published in the Federal Register. The new rule will retain an enforcement mechanism set up under the 2008 regulation, but will mostly jettison the rest of it.

"Strong conscience laws make it clear that health care providers cannot be compelled to perform or assist in an abortion," said HHS in a statement. "Many of these strong conscience laws have been in existence for more than 30 years. The rule being issued today builds on these laws by providing a clear enforcement process."

The agency proposed rescinding the Bush rule in March 2009 and received more than 300,000 comments on the proposed rule; the majority of which were form letters generated by various organizations, HHS said. More than 97,000 supported a rescinding of the 2008 rule, about 187,000 opposed any revision, and the rest were of various opinions.

NARAL Pro-Choice America, which claimed to have generated more than 25,000 of the comments, applauded the change. "The language published today reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts of Bush’s last-minute refusal rule," said President Nancy Keenan in a statement.

The rule goes into effect on March 18.