Wednesday, April 15, 2015

Senate Passes Permanent SGR Fix

Drew Thies

Late Tuesday night, the Senate sent a bill permanent repealing the sustainable growth rate (SGR) to the President’s desk. The legislation passed overwhelmingly, with 92 Senators voting for passage. President Obama released a statement last night saying he will be “proud to sign it into law.”

This bipartisan effort marks the end of annual funding fights over “doc-fixes” that have dominated health policy for over a decade.

The House passed its version of the bill two weeks ago, but the Senate did not have enough procedural time to take up the legislation before a two-week holiday recess. The legislation moved out of the Senate just hours before physicians would have seen a 21 percent cut in Medicare payments due to expiration of the previous doc-fix.

The bill was passed with 46 Republicans and 44 Democrats plus 2 Independents voting in favor. The 8 Republican Senators opposing the bill were Sens. Ted Cruz, Mike Lee, David Perdue, Marco Rubio, Ben Sasse, Tim Scott, Jeff Sessions and Richard Shelby.

Final passage of the House-approved measure was uncertain as late as Tuesday, when both parties brought up three amendments each. Any amendment to the bill would have fundamentally changed the structure of the agreement and forced the House to approve a final version.

Republicans offered amendments to repeal the individual mandate within the Affordable Care Act, fix physician payments at .5% for the duration of the legislation, and strike the "pay-go" exemption, triggering sequester cuts if the bill is not fully paid for by the end of the year.

Democrats offered amendments to extend SCHIP provisions from two years to four years, remove abortion-related language in the bill, and permanently repeal the therapy caps as opposed to the two-year exception currently in the bill (which only failed to pass by two votes).

The current payment system will remain in place for five years as providers transition to the new Merit-Based Incentive Payment System (MIPS). Physicians will be paid more if they meet quality criteria, which are currently being developed.

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