May 2015
It’s almost over! The SGR debacle will soon be behind us. I am writing this the morning after the Senate passed by a vote of 92-8 H.R. 2 – legislation to repeal and replace the Medicare Sustainable Growth Rate formula. While a few amendments were debated by the Senate, none were adopted and the House and Senate have now passed identical bills which President Obama has signed.
Enactment of a permanent SGR fix is a big relief and a big deal – in the near term and the long term. In the near term, enactment means physician and other Part B providers will avoid a 21% cut in reimbursements and will instead receive a 0.5% increase in payments for services provided April 1, 2015 or later. There will also be a 0.5% payment increase in years 2016-2019. In addition, CMS will start processing claims it has been holding since April 1.
As for long term implications, the bill accelerates the transition to Medicare payments based on quality reporting, speeds the adoption of voluntary alternative payment models and makes important changes to CMS quality incentive and payments systems (see SGR legislation article for more details).
While I am relieved that the SGR mess is finally over, I am frustrated that it took over 10 years to fix what should have been a simple problem. Congress repeatedly took the easy way out with temporary patches, making the problem worse every year. I hope our national leaders can show more wisdom in future.
Not allowing my frustration with the past cloud my vision for the future, fixing SGR is a win for patients and providers alike. Now on to the next challenge!
Sincerely,
Alan L. Plummer, MD
Editor
