With a 24 percent cut to Medicare payments set to go into effect April 1 when the latest Sustainable Growth Rate (SGR) patch expires, time is ticking for Congress to complete work on permanently repealing the flawed formula.

The House and Senate recently introduced the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015/ S. 2000), a bill that would eliminate the SGR and replace it with a new Medicare payment system that would reward high quality, evidence-based care. Of note, the bicameral, bipartisan legislation includes a 0.5 percent physician payment increase each year for five years which would provide stability to physicians and allow for a smooth transition to new care models. Additionally, it incentivizes adoption of clinical data registries and adherence to specialty society endorsed appropriate use criteria.

Additional Resource AMA SGR Comparison Chart: Current law vs. proposals

According to a summary released on Feb. 6, the bill:

• Consolidates existing payment incentive programs into a single Merit-Based Incentive Payment System, in which high-performing professionals would earn payment increases
• Incentivizes care coordination efforts for patients with chronic care needs
• Makes payment data on providers more publicly available
• Implements a process to re-base misvalued codes
• Requires development of quality measures in close collaboration with physicians.

Since the bill does not address how the estimated $120-$150 billion cost of repeal would be funded, passing this legislation is still an extremely heavy lift and another temporary patch is a distinct possibility.

"We applaud the tremendous effort put forth by your committees," said ACC President John Gordon Harold, MD, MACC, in a letter to the committee chairs. "We caution that our final support rests upon the caveat that paying for this legislation must not negatively impact access to lifesaving cardiology services." 

In addition to the letter sent to committee chairs, ACC has taken the following action to push the bill forward:

• The College has banded together with other medical associations on an advertising campaign aimed at lawmakers. Starting Feb. 25, a print ad is running in Roll Call every Tuesday and Thursday and a digital ad is running on Politico.com through March 2.
• A Grassroots Action Alert has been activated and ACC members are urged to use the alert to contact their members of Congress.
• ACC leaders gathered in Washington, DC, on Feb. 11 to bring the College’s message directly to key members of Congress and their staff. Read more on the ACC in Touch Blog.
• The College signed on to a letter circulated by the American Medical Association to all medical specialty societies.

Stay tuned for developments.

Keywords: Financial Management, Registries, Single-Payer System, Thiadiazines, Medicare, United States

< Back to Listings