With no agreement yet in Congress, physicians continue to move closer to a 27 percent cut in Medicare reimbursement on Jan. 1 due to the sustainable growth rate (SGR) formula. This week, the U.S. House passed the Middle Class Tax Relief and Job Creation Act of 2011, which would halt the SGR cut for two years and replace it with 1 percent positive updates. The legislation now goes to the Senate for consideration, but Senate Democratic leaders have said there are not enough votes to pass the bill. They cite controversial offsets to cover the bill's cost, including cuts in funding to the health-care reform law.

The $39 billion SGR fix included in the House bill was championed by the Republican doctor caucus in response to physicians' advocacy for stability in Medicare pay. The Academy and most medical associations, however, did not endorse the bill because it leaves physicians facing a 37 percent pay cut in 2014.

The House bill pays for the two-year SGR fix through cuts in hospital payments, including elimination of a 44 percent differential that hospital outpatient departments receive for evaluation and management visits. Although Senate leaders are seeking bipartisan support to advance an alternative package, they are meeting with little success. There is little support in the Senate for an SGR fix paid for with Medicare cuts. The Academy provides tools for members to reach their legislators to advocate for a Medicare physician pay fix. In addition, the AMA grassroots hotline is available to reach members of Congress at 800.833.6354.