SGR Repealed with Passage of H.R. 2 April 15, 2015 Advocacy, Medicare, Payment CHIP, H.R. 2, SGR, SGR repeal 0 The San Francisco Medical Society (SFMS) applauds the House of Representatives, the Senate, and President Obama for milestone passage of the "Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act" (H.R. 2) that permanently repeals the sustainable growth rate (SGR) formula, which has plagued the nation's health care infrastructure for more than a decade. The SGR, originally enacted as part of the Balanced Budget Act of 1997, has been patched 17 times in the years since then, and a 21.2% rate reduction for all physicians was scheduled to take effect on April 15, 2015. The House of Representative passed H.R. 2 on April 2, 2015 with an overwhelming vote of 392-37. Last night, the Senate approved the bill with a 92-8 vote, and President Obama formally enacted H.R. 2 with his signature. The bill, drafted by House Speaker John A. Boehner and Minority Leader Nancy Pelosi, not only repeals the Sustainable Growth Rate (SGR) payment formula that perennially threatened patients’ access to care, but also extends the Children’s Health Insurance Program for two years through 2017. Medicare should begin processing claims for services provided in April at the rates that were effective before the 21% cut was scheduled to take effect. Under the provisions of H.R. 2, the fee schedule conversion factor will be increased by 0.5% on July 1, 2015, and by another 0.5% on January 1, 2016. SFMS thanks Leader Pelosi and Senators Boxer and Feinstein for their efforts to repeal SGR. We would also like to extend a sincere thank you to all physicians for the extraordinary campaign this last decade to end the SGR. This feat could not have been achieved without the unity within organized medicine. We celebrate this achievement for our patients. Key provisions of H.R. 2 Repeals the SGR Provides automatic, stable 0.5% updates each year for 4 years In 2019, physicians can choose to participate in one of two payment track options: Fee-for-Service Track that simplifies and consolidates the existing quality reporting programs, reinstates large bonuses up to 9% and reduces current penalties; or, Alternative Payment Model Track that provides 5% bonus payments and allows physicians to develop the new models, such as primary care/specialty medical homes. $125 million in funding to help small practice physicians transition to the alternative models or quality reporting programs. Reinstates bundled payments for the 10-day and 90-day global surgical services Provides total cost of care data to help physicians better manage their practices Mandates interoperability of EHR systems Extends the expiring Children’s Health Insurance Program (CHIP) for 2 years at the higher ACA funding levels. It covers nearly 1 million children in California who would otherwise lose their insurance. Extends the important National Health Service Corps Program and the Teaching Health Centers Rural Primary Care Residency Training Programs (created in the ACA) through 2017. There are several teaching health center residency programs in California. Extends the moratorium on RAC audits of the hospital two-midnight rule which helps hospitals and physicians Delays the ACA cuts to Disproportionate Share Hospitals for one more year Comments are closed.
