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January 29, 2010


Senate Takes Action on SGR in Debt Limit Bill

Yesterday, the Senate moved one step closer to averting the looming 21.2 percent cut in Medicare reimbursements to physicians by passing an SGR pay-go exemption provision to the debt limit bill that passed the chamber. The debt limit bill amended Senate rules to require that all future increases in federal spending must be offset with either reductions in other federal spending or increases in revenue. The rules are frequently referred to as "pay-go" rules or "pay as you go" requirements.

However, the bill that passed the Senate exempted certain types of spending, including up to $82 billion to prevent the SGR cuts. It is estimated that it will cost $82 billion to provide a 0.0% Medicare physician payment update over the next 5 years. A permanent repeal of the SGR formula is estimated to cost an additional $130 billion.

While the Senate action is welcome news for the physician community, it is not the end of the process. Effectively, the Senate only figured out how to pay for fixing part of the problem. They have not yet passed legislation that actually fixes the SGR problem - temporarily or permanently.

The ATS and rest of the physician community will continue to demand that Congress act swiftly to pass legislation permanently replacing the SGR formula


EPA Issues New NO2 Standard

Last week, the EPA announced final rules for the nitrogen dioxide (NO2) standard, creating a new 100 parts per billion (ppb) limit on one-hour concentrations, while maintaining the 53 ppb annual limit, which has been in place since 1971. The EPA simultaneously announced changes to its NO2 monitoring and reporting network to determine compliance with the new one-hour standard, stating that additional monitors are required near major roads and urban areas where ambient levels of NO2 are most likely to see the spikes exceeding 100 ppb.

The ATS played an active role in supporting the new stricter standard, including publishing an editorial calling for tighter standards in The American Journal of Respiratory and Critical Care Medicine, submitting written comments and testifying at regional EPA field hearings.

While the new one-hour limit represents an improvement to the previous standards, there is ample room for improvement. High levels of NO2 are especially known to put the very young and very old and people with asthma and other respiratory problems at risk for increased medical problems. The limit of 100 ppb is an improvement over no limit, but the ATS supports lowering the standard to 75ppb.


Points of Contact

Gary Ewart Senior Director, Government Relations
Nuala Moore Senior Legislative Representative
Joe Kirby DC Office Administrator