A
subcommittee of the House Energy and Commerce Committee approved
legislation on July 23 that would finally scrap the flawed physician payment formula for
Medicare, known as the Sustainable Growth Rate (SGR).
Under the
legislation, the SGR payment formula would be retired at the end of 2013. Starting
in 2014, reimbursements under fee-for-service Medicare would be increased 0.5% each
year. After 2019, physicians in fee for service would get an additional 1% for
meeting certain quality measures, which are yet to be determined.
This legislation does not change payment arrangements
for physicians currently practicing in a Medicare ACO. Physicians could choose to participate in other alternative
payment models, as long they’re approved by the federal government. The
incentives favor physicians who are willing to take the necessary steps to
participate in new approved models.
The subcommittee’s bill is the first step of what will probably be a very long road to reforming the Medicare payment system. Lawmakers have not yet identified how to pay for the bill. A vote by the full committee is expected before Congress’ August recess, which is scheduled to begin Aug 1.
The MMS will
work with the state congressional delegation and the AMA to ensure that the payment updates are appropriate, and that
the issues specific to small practices are adequately addressed.
The AMA said it was pleased with the progress made to ending the SGR. But it noted, “The details matter considerably, and there is still work to be done to ensure a strong future for Medicare.”
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