SGR Repeal Legislation Introduced February 6, 2014 Advocacy, News, Payment Medicare, Sustainable growth rate, SGR 0 Physicians will get a 0.5% pay increase each year for 5 years under a deal by a bipartisan team of House and Senate negotiators to repeal the sustainable growth rate (SGR) formula for physician payment under Medicare. Staff for the chairmen and ranking minority members of the three Congressional committees of jurisdiction briefed physician groups this afternoon on the results of their bicameral, bipartisan negotiations on repealing the SGR. The “SGR Repeal and Medicare Provider Payment Modernization Act of 2014,” which was introduced by Rep. Michael Burgess, MD (R-TX) in the House as H.R. 4015, addresses only the policy provisions related to eliminating the flawed payment update formula. It does not include financial offsets or any of the usual extender policies. Key provisions include: The SGR would be repealed immediately. Positive annual payment updates of 0.5% would be provided for five years. The Value-Based Performance (VBP) program has been replaced with a similar Merit-Based Incentive Payment System or MIPS, which includes prospectively-set performance thresholds and offers flexibility in the imposition of performance requirements that are inappropriate for some specialties. The effective date of the MIPS program would be one year later than the original VBP proposal, and will start in 2018. The MIPS funding pool was increased and is no longer budget neutral, and the phase-in of penalty risks for those who fall in the lowest performance quartile has been capped at a maximum of 9% (as opposed to the previous 12%). The 5% added incentive payment for physicians in Alternative Payment Models was retained. Funding for technical assistance to small practices of 15 or fewer professionals was doubled. Provisions similar to the Standards of Care Protection Act are included. Physicians who opt out of Medicare to engage in private contracting with their patients would no longer be required to renew their opt-out status every two years. Members of the Congressional Doctors Caucus were heavily engaged throughout the negotiations until late last night, pursuing the policy goals they outlined in a letter last December. An official section-by-section summary of the legislation is attached. In a budget-tight Congress that deals with many healthcare interests, many in Washington have said paying for an SGR repeal will be the most significant hurdle to clear. Physician payments are set to fall by nearly 24% on April 1 unless Congress forestalls the cuts again or repeals the SGR. Comments are closed.
