Monday, December 9, 2013

SGR Reform Efforts Continue Forward

By Drew Thies

Numerous news outlets reported this week on work in Congress to reform the current Medicare Physician Payment Schedule, though key players predicted the process will continue into 2014.

Both the Senate Finance and House Ways and Means committee are expected to mark up and vote next week on a proposal which permanently reforms the Sustainable Growth Rate (SGR). The plan, a rare bipartisan, bicameral framework in a Congress currently dominated by partisanship, seeks to move away from fee-for-service payments to value-based approaches. The framework is supported by AHCA.

Rep. Dave Camp (R-MI), chairman of Ways and Means, released a statement Thursday expressing optimism about the chances for SGR reform: “The committee has made real progress on a bipartisan and bicameral bill. If that progress continues, I expect the committee to consider the legislation before the end of next week.”

Rep. Kevin Brady (R-TX), who heads the Ways and Means Health Subcommittee is also “hopeful we can reach consensus here soon,” and have it finalized by “early next year to hop aboard any train to the president’s desk.”

The Congressional Budget Office found the proposal would cost $139.1 billion over 10 years—much lower than previous years but still a substantial sum to offset in a Congress already scarred by funding battles this year.

However, next week is also the last week Congress is scheduled to be in session, making a permanent fix to the SGR unlikely for 2014.  If legislation is not passed before Members of Congress leave for the Winter Recess, another stopgap “doc fix” will have to be enacted if physicians are to avoid a 20 percent cut for physicians in January.

AHCA staff continues to monitor the situation and ensure that skilled nursing is represented in these negotiations.

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