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Medicare SGR reform gains ground, but payment plan still undecided
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The American Medical Association praised what it called “strong bipartisan votes” by two Congressional committees to replace the current Medicare sustainable growth rate formula and end the “annual cycle of draconian Medicare physician payment cuts and short-term patches” on physician reimbursement.
The House Ways and Means and Senate Finance committees both passed versions of the bill on Dec. 12, including what an AMA statement calls a plan to “consolidate and restructure existing quality improvement incentive programs to reduce the administrative and financial burden on physicians.”
Action by the full House and Senate on how to fund the reforms was not expected in 2013. The Congressional Budget Office now estimates the cost of repealing SGR to be about $116.5 billion over a decade.
Sen. Rob Portman, R-Ohio, said during the hearing: “We’re not hitting the big issues of Obamacare and the effect on our constituents. We’re not going to be able to support this [SGR reform] at the end of the day unless it has a pay-for.”
But there was vocal legislative enthusiasm during the Senate hearing for doing something.
“Enough is enough for Band-Aid solutions. It is time to act. Finally, not a 1-year patch,” Senate Finance Committee Chairman Max Baucus, D-Mont., said to cheers from fellow committee members. “Our bill reflects input from the entire medical community. We all share the same goal.”
The votes “show that there is overwhelming, bipartisan support for ending the SGR in a fiscally responsible manner,” AMA President Ardis Dee Hoven, MD, said in a statement.
Revisions to the draft in the House include:
- 3 years of 0.5% updates to payments under the Medicare physician fee schedule
- provisions to limit inappropriate medical liability claims
- the ability for physicians who privately contract with Medicare patients to automatically renew their 2-year opt-out at the conclusion of each cycle
- a 2017 deadline for electronic health record vendors to make their systems interoperable
“Once the bill is out of committee we will sit down to find suitable offsets,” Sen. Orrin Hatch, R-Utah, said during the hearing. “This bill will be paid for.”