Wednesday, January 16, 2019

It's Finally Over! The Medicare SGR is Dead!

LAST NIGHT THE SENATE APPROVED H.R. 2: THE MEDICARE SGR REFORM AND THE CHILDREN’S HEALTH INSURANCE REAUTHORIZATION ACT WHICH REPEALS MEDICARE’S SUSTAINABLE GROWTH RATE FORMULA, HOURS BEFORE DOUBLE-DIGIT PAYMENT CUTS TO PHYSICIANS WERE SET TO TAKE EFFECT. THE BILL HAS BEEN SENT TO THE WHITE HOUSE WHERE PRESIDENT OBAMA IS EXPECTED TO SIGN IT INTO LAW.

After a decade of battling, the U.S. Senate, in a whopping vote of 92-8, passed H.R. 2, the monumental, bipartisan Medicare SGR Payment Reform and Children’s Health Insurance Program (CHIP) Reauthorization Act. Both California Senators Feinstein and Boxer voted in the affirmative. Two weeks earlier, the U.S. House of Representatives adopted the legislation in a landslide vote of 392-37. This was a rare, bipartisan achievement in a deeply divided Congress. RCMA, CMA, AMA and more than 780 state and national physician organizations supported the bill. In 2013, the policy was jointly developed on a bipartisan basis by the three House and Senate health committees. This year, U.S. House of Representatives Speaker John Boehner (R-OH) and Minority Leader Nancy Pelosi (D-CA) are credited with negotiating the final budget offsets to fund the SGR bill.

RCMA/CMA extends a sincere thank you to all physicians for the extraordinary campaign this last decade to end the SGR. We have kept up the fight these last two years to hold Congress’ feet to the fire to develop a comprehensive bill to reform Medicare physician payments. The unity within organized medicine finally put this over the finish line. Moreover, 52 out of 54 Members of the California Congressional delegation voted to support physicians. This is an incredible achievement in one of the most dysfunctional Congresses in history.

PLEASE BE SURE TO CONTACT YOUR REPRESENTATIVE AND
THE CALIFORNIA SENATORS TO THANK THEM FOR THEIR SUPPORT!

While H.R. 2 is far from perfect, it represents a significant improvement over the current Medicare program which mandates penalties up to 13% in the coming years with no opportunities for payment updates or bonuses. This bill consolidates the burdensome reporting programs and reinstates significant bonus payments. By repealing the SGR and providing annual updates, it provides stability to physician practices that allows for longer term planning. Significantly, it allows physicians to design new payment systems that work for physicians and patients instead of government bureaucrats. And it mandates physician involvement in defining and developing quality measures. Moreover, once the costly SGR is repealed, it will be much easier for physicians to work with Congress to make improvements to the payment system (such as increasing the annual update) at a lesser cost. The enormous cost of the SGR has been a barrier to making any improvements.

Note that Medicare should begin processing claims today for services provided in April at the rates that were effective before the 21 percent cut was scheduled to take effect. Under the provisions of H.R. 2, the fee schedule conversion factor will be increased by 0.5 percent on July 1, 2015, and by another 0.5 percent on January 1, 2016.

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