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Tuesday, December 10, 2013

IT'S SHOWDOWN WEEK ON SGR REPEAL

A number of developments late last week on the repeal of Medicare’s Sustainable Growth Rate (SGR) formula will make for some interesting Washington watching over the next few days as Congress prepares for the December recess. “I expect the committee to consider the legislation before the end of next week,” said House Ways and Means Committee Chair David Camp (R-Mich.). The Senate Finance Committee has hearings scheduled for this week. The Congressional Budget Office cut the 10-year cost estimate for repealing the physician payment formula from $139 billion to $116.5 billion. We’re hoping that will add to the momentum to finally eliminate this albatross from around physicians’ necks. Also, the Ways and Means Committee and Finance Committee released a new framework for the repeal legislation. It still has no guarantee for any Medicare payment increases (“positive updates” in Washington parlance). However, the revised plan would reduce the potential penalties for the “value-based performance program” that would replace several existing bonus/penalty programs like meaningful use and the Physician Quality Reporting System. It also would give practices more time to transition away from fee-for-service and into “alternative payment models.” Absent any congressional action, the SGR mandates a 24-percent cut in physician’s Medicare payment rates beginning Jan. 1. Given the tight time frame, many Congress watchers are predicting that a full repeal bill will not pass before lawmakers go home for the holidays. Given all of that, here are TMA’s priorities:
  • Continue the progress toward full repeal of the SGR;
  •  Include positive updates for physicians who have been strapped with a decade-long freeze in their Medicare payments;
  • Ensure that any short-term “bridge” to forestall the 24-percent cut doesn’t cause payment delays, cash-flow problems, and accounting headaches for physicians — as we’ve seen in the past; and
  • Include relief for physicians from the growing multitudes of onerous regulations that add cost to medical practices but add no value to patient care.

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