The legislation — which the House passed last week — would protect physicians until the end of March 2015 from a 24 percent reimbursement reduction due to take effect today under the SGR. The patch would be the latest in a series of short-term legislative solutions Congress has enacted every year since 2003 to stave off double-digit Medicare pay cuts for physicians under the SGR.
The American Medical Association has opposed the measure, pushing for a permanent SGR solution rather than another temporary fix. “Full repeal of the sustainable growth rate formula is the answer to strengthening the Medicare program, not another patch,” AMA President Ardis Dee Hoven, MD, said in a statement released by the organization.
The House has passed a bipartisan measure that would permanently solve the SGR issue by repealing the formula and replacing it with a payment system that incentivizes physicians to provide high-quality, low-cost care. However, the bill has not yet passed the Senate, and the White House has indicated President Barack Obama will veto the legislation if it reaches his desk because of an amendment delaying the individual mandate.
The latest SGR patch bill would also delay enforcement of the controversial two-midnight rule by six months. The two-midnight rule was established by the 2014 Medicare inpatient prospective payment rule, and enforcement is currently scheduled to begin this October. According to the policy, inpatient admissions spanning at least two midnights qualify for Medicare Part A payments. Inpatient stays lasting fewer than two midnights must be treated and billed as outpatient services. Hospital leaders, physicians and healthcare groups have fiercely opposed the rule, saying it is unclear and undermines the medical judgment of physicians.
Finally, the bill would also delay the implementation of ICD-10 to Oct. 1, 2015. Last week, the American Health Information Management Association called on its members to contact members of Congress and voice opposition to the bill. CMS has estimated a one-year delay of ICD-10 could cost between $1 billion and $6.6 billion, according to AHIMA.
More Articles on the SGR:
House Passes Bill Linking SGR Patch to ICD-10 Delay
AMA Opposes Temporary SGR Patch
House to Consider Bill Linking SGR Fix to ICD-10 Delay
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