Bipartisan House Bill Aims to Repeal Medicare's SGR
introduced new legislation that would permanently repeal the sustainable growth rate, which dictates Medicare reimbursement to physicians.
The bill, the Medicare Physician Payment Innovation Act of 2013, would wipe out the SGR formula and provide positive annual updates for all physicians — primary care and specialists — over the next four years. In addition, it would stabilize fee-for-service Medicare payment rates for providers who have better quality results, and it would test new payment and delivery models that emphasize value.
Every year since 2003, Congress has overridden the SGR so physicians would not have to endure sizable cuts to their Medicare pay. Physicians would have faced a 26.5 percent reduction this past January if a fix had not been included in the fiscal cliff legislation. If Congress does not repeal or temporarily fix the SGR again, physicians will face a 30 percent Medicare payment cut on Jan. 1, 2014.
The legislation coincides with a report from the Congressional Budget Office, which drastically lowered its estimate of how much it would cost to repeal the SGR. The CBO now estimates the cost to repeal the SGR stands at $138 billion compared with its previous figure of $245 billion. However, the bill did not say how the $138 billion cost would be covered.
"For over a decade, this policy has failed taxpayers, Medicare beneficiaries and those on the frontlines of patient care," Rep. Schwartz said in a news release. "The framework for this legislation has garnered broad bipartisan support over the past year…there is not excuse for further inaction."
Several provider organizations, including the American College of Physicians and the American Medical Association, praised the bill, saying the effort will hopefully lead to the end of a "decade-long cycle of scheduled cuts and short-term patches."
"This legislation is an important part of the continuing discussion on the future of Medicare and the end of the SGR," AMA President and CEO Jeremy Lazarus, MD, said in a news release. "We look forward to continuing to work with Reps. Schwartz and Heck and their colleagues on both sides of the aisle to move past the SGR and transition to an array of Medicare delivery and payment options that give physicians the flexibility they need to help lower costs and improve the quality of care for their patients."
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