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Monday, November 2, 2009


The Centers for Medicare & Medicaid Services (CMS) made it official. Unless the U.S. Congress takes action — as part of global health system reform or in a separate bill — physicians’ Medicare and TriCare payments will be cut by 21.2 percent starting Jan. 1, 2010. The cuts are mandated by the SGR formula in current law. “Access to care and choice of physician for seniors, baby boomers, and military families is at serious risk — and Congress must fix the payment formula once and for all this year,” said AMA President Jim Rohack, MD. CMS published the final rule, which also includes changes in the Physicians Quality Reporting Initiative and formalizes bonuses and penalties for meaningful use of electronic medical record systems. Here’s the status of legislation to repeal the SGR:
  • After the U.S. Senate refused to take up S 1776 last month, Senate Majority Leader Harry Reid (D-Nev.) announced that senators will consider new Medicare payment legislation after passage of a health system reform bill.
  • On the House side, Speaker Nancy Pelosi (D-Calif.) unveiled a separate bill to replace the SGR with a new formula based in part on physicians’ cost of providing Medicare services. The speaker has not announced whether the House will combine the bill with the Affordable Health Care Act or take it up as separate legislation.

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