Sample Letter to Your Members of Congress on the Physician Fee
The Honorable (Full Name)
House of Representatives
Washington, DC 20515
Dear Representative (last name):
The Honorable (Full Name)
United States Senate
Washington, DC 20510
Dear Senator (last name):
As a practicing [vascular technologist/sonographer/physician] in [city, state] and a
member of the Society for Vascular Ultrasound (SVU) for over xx years, I am writing to
express my concern about the inadequate payment mechanism that is used to pay for a
variety of services under the Medicare physician fee schedule, including the critical,
inexpensive, and efficient diagnostic services that I perform using ultrasound
Founded in 1977, SVU is the only professional organization completely dedicated to the
advancement of non-invasive vascular technology used in the diagnosis and treatment of
vascular disease. SVU has more than 3,900 vascular technologist/sonographer and
Because SVU actively monitors policies affecting the welfare of our profession and the
patients whom we have the privilege to serve, I have become familiar with the
controversy surrounding the instability of the conversion factor that is used to determine
physician payment under the Medicare physician fee schedule. With the risk of a huge
decrease in Medicare reimbursements for physician fee schedule services pending, I ask
you to act now to secure a permanent fix to the conversion factor problems.
Supporting the “Preserving Patient Access to Physicians Act of 2005” (H.R. 2356 and S.
1081) is a critical step towards that end. These bills establish an update to the single
conversion factor for 2006 of at least 2.7 percent, and a formula for an update to the
single conversion factor for 2007.
I strongly agree with the clear consensus that includes the physician community,
MedPAC, and a variety of prominent Members of Congress that the sustainable growth
rate (SGR) formula that is currently used to determine physician payment is ineffective
and ultimately impedes beneficiaries' access to quality health care services. I appreciate
that Congress sought to temporarily address this concern in the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (MMA) by implementing a positive
1.5 percent update as a floor in the conversion factor for 2004 and 2005 in order to
prevent the 4.5 percent reduction in physician payments that the Centers for Medicare
and Medicaid Services (CMS) had anticipated.
I also recognize that this followed the temporary legislative measure that Congress
previously took to enable CMS to remedy projection errors that were made in the
physician fee schedule updates from 1998 and 1999. In both cases, the "temporary fixes"
were intended to provide Congress with time to reevaluate the feasibility of the SGR
system. However, these temporary "fixes" are clearly inadequate in addressing this
important issue on a long-term basis.
Accordingly, I respectfully request that you seek to rectify the considerable deficiencies
that have been identified by the relevant stakeholders now. Most notably, recent
Congressional testimony by the Chairman of MedPAC reinforced the failure of the SGR
system to associate the payment of physicians with the costs of providing health care
services or to account for the variations in volume and quality control among individual
physicians. My understanding is that, if these deficiencies are not addressed, physicians
will receive reductions in payment of approximately 5.0 percent on an annual basis from
2006 until 2012. This projection is alarming in light of the projected increases in the costs
of providing health care services. Consequently, it has negative implications for
beneficiary access to quality care that must not be ignored.
I urge you to ensure that Congress responds to the call of its constituents by developing
and implementing a long-term strategy to reconcile the physician payment system with
the actual costs of delivering health care services. Statutory changes to the Medicare
physician payment system are sorely needed to protect beneficiaries' access to quality
care. I would greatly appreciate your leadership in effectuating those changes.
[full name and address of SVU Member]