House Committee Approves Bipartisan Medicare SGR Reform Bill July 29, 2013 Advocacy, Medicare, News, Payment SGR, #FixSGR, House Energy and Commerce Committee, Medicare SGR, Sustainable Growth Rate 0 Last week, in a short 15-minute meeting, the House Energy and Commerce Committee’s Health Subcommittee approved the bipartisan legislation that repeals the Medicare Sustainable Growth Rate (SGR), provides a transition period, and a pathway to a new payment system. An amendment was adopted during the mark-up making technical changes to the legislation, but no significant changes were made in the policies set forth in the original bill. While SFMS/CMA has concerns with the legislation, particularly the penalties, we are pleased that Congress is moving forward with a bill to eliminate the SGR and establish a stable payment system. CMA will continue to advocate our goals to Congress as this bill is a work in progress. The bill follows previous outlines that repeal the SGR, provide a period of stability, provide updates for physicians participating in fee-for-service quality measure and clinical improvement projects and gives physicians incentives to participate in alternative payment models. Here is a short summary with important additional highlights and details below. Summary Repeals the SGR Provides a Period of Stability for 5 years with 0.5% annual payment updates Allows physicians to choose to participate in a fee-for-service (FFS) program or an alternative payment model. In 2019, for those physicians participating in FFS, it provides up to 1.5% updates for reporting on physician-developed quality measures and for participating in physician-developed clinical projects. Physicians who score poorly will be subject to a net 0.5% cut. Alternatively, physicians may choose to participate in physician-developed alternative payment models. The incentives favor physicians who are willing to take the necessary steps to participate in new models. SFMS/CMA Advocacy There are several aspects of the bill that concern SFMS/CMA, including the downside penalties. Moreover, many details still need to be worked out. However, the bill meets many of the goals that SFMS/CMA advocated to Congress to eliminate the annual threat of nearly 30% SGR payment cuts, 5 years of stable updates, a continuation of the FFS program with opportunities for updates and incentives to help physicians transition to new payment and delivery models. SFMS/CMA is still working to include a payment locality update (“CA GPCI Fix”) in the SGR legislation. We have given Congress several options to move the localities to Metropolitan Statistical Areas while mitigating the cuts to the rural counties The bill does include a CMA-sponsored medical liability provision that will ensure that any new payment policies or practice guidelines contained in the Affordable Care Act (ACA) do not establish a new standard of care for medical liability proceedings. Read the complete draft legislation here. Read a summary of the draft here. Review major milestones in the committee's efforts to reform the SGR here. Click here for SFMS/CMA's analysis of the bill. Comments are closed.
