ASA Achieves Historic Legislative Win of Monumental Proportions!

We helped secure enactment of H.R. 6331—a
Medicare bill that includes an immediate positive
Medicare payment update and a permanent
fix to the Medicare Anesthesiology
Teaching Rule, beginning in 2010! This is a huge victory for the medical specialty
of anesthesiology, organized medicine and
America’s patients. It is a culmination of many
years of work with the Centers for Medicare &
Medicaid Services (CMS) and two yearswith Congress
as well as coalitions within the federation of
With the passage of H.R. 6331, anesthesiologists
and other physicians will see a continued
0.5-percent positiveMedicare payment update for
the rest of 2008 and a 1.1-percent positive update
in 2009—rather than a 10.6-percent cut that took
effect on July 1, and a projected 15-percent cut
that had been slated for January 1, 2009.
Further, after more than a decade under an unfair
policy, anesthesiology teaching programs
will, beginning in 2010, receive full Medicare
payment! Since 1994, anesthesiologists have
faced a 50-percent payment penalty when overseeing
two residents on overlapping cases. The
newly-passed law will correct this payment inequity,
strengthening our residency programs in
the process.
Congratulations and gratitude to all who participated
in this successful effort!
In recent years, I often have been asked why I
spend so much time being an active member of
ASA. Many of my other medical colleagues are
not members of their professional organizations,
and they cannot understand why I want to be so
engaged with my specialty organization. Other
peers are members of their societies but do little
or nothing but pay their yearly dues.
Mostly my answer is because I truly believe in
what we do, ultimately enjoy the friendships, and
know that to make a difference in the profession,
we need to have the power of numbers.
This legislative victory proves just what numbers
can do.
In terms of the sustainable growth rate (SGR),
ASA joined forces with the rest of organized
medicine to push Congress for a positive
Medicare payment update. First, we responded
in strong number to initial attempts at a legislative
payment fix. In fact, nearly 500 anesthesiologists
were in Washington, D.C., as part of the
2008 Legislative Conference, and they were all
lobbying for SGR reform.
When the first bill didn’t make it through,
thousands of ASA members called their Representatives
and Senators in support of H.R. 6331,
which passed the House with a bipartisan 355-59
vote — a blowout by any standard. Even when
H.R. 6331 couldn’t seem to gain traction in the
Senate, ASA Key Contacts and grassroots advocates
stayed strong, keeping on the pressure until
the Senate passed H.R. 6331 by a bipartisan vote
of 69-30.
Not even a Presidential veto could thwart
ASA members.When we issued an urgent action
alert after President Bush’s veto, ASA members
responded — and played a big part in the veto
override, securing another bipartisan 383-41 vote
in the House and a bipartisan 70-26 vote in the
Throughout the process, ASA staff, leaders
and members worked strategically and relentlessly
to ensure inclusion of Medicare anesthesiology
teaching rule reform language in the final
Since ASA first secured introduction of
Teaching Rule legislation in 2006, thousands of
dedicated ASA members reached out to their
Representatives and Senators for support of the
bills. In 2008 alone, we secured 127 bipartisan cosponsors in the
House and 30 bipartisan cosponsors in the Senate. Our strong
sponsors — Rep. Xavier Becerra (D-CA) of H.R. 2053, and Sen.
Jay Rockefeller (D-WV) and Sen. Jon Kyl (R-AZ) of S. 2056 —
helped ensure that the proper bill language eventually became law.
I would like to personally thank all component society leaders,
Key Contacts, committee members, officers, and other ASA
members who contacted their lawmakers in support of H.R. 6331.
This absolutely would not have been possible without your continued
I also commend and congratulate our staff inWashington, D.C.
and our outside consultants, whose expertise and strategic guidance
laid the foundation for such a huge win. They worked directly
with members of Congress on sound policy, facilitated an
outpouring of member support for this legislation, and tactically
engaged in coalitions with other organizations, including the
American Medical Association (AMA), to ensure final passage.
ASA members should feel proud of the hard work that their association,
ASA, did on their behalf. They should also pat themselves
on the back for the dedication and perseverance they
displayed throughout this fight!
ASA and its members, leaders and staff embody the mission of
anesthesiologists.We have advocated for physicians and the patients
they serve for more than 100 years, and we will continue doing so.
We support research, educate physicians and patients, and advocate
for regulations and laws that ensure patient access and safety.
As your colleague and as your President for this year, I thank
you for being a member of ASA, and rejoice with you on this momentous
legislative victory!

Reviewed by Ramaz Mitaishvili, MD

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