Representatives introduce bill to eliminate Medicare SGR formula

Rep. Allyson Schwartz (D-Pa.) and Rep. Joe Heck (R-Nev.) have introduced a bill they hope will eliminate the Medicare Sustainable Growth Rate formula and create a pathway to better payment models.

The Medicare Physician Payment Innovation Act of 2012 is designed specifically to discard the Sustainable Growth Rate (SGR) formula and stabilize payments for 6 years, according to an American College of Physicians release wherein the group praised the bill’s introduction.

“Over the past decade, the repeated threat of cuts to physician payments resulting from the SGR have brought chaos to the practice environment,” David L. Bronson, MD, FACP, president of the American College of Physicians, stated in the release. “We enthusiastically support this legislation. It not only addresses the continued thread of the SGR formula, it also moves Medicare beyond a pure fee-for-service payment model toward new models that better align payment with value.”

According to the release, the new legislation will:

  • repeal the SGR — an act reportedly paid for through the use of money that has already been set aside and will never be used;
  • eliminate all scheduled SGR cuts, including the nearly 30% cut scheduled for Jan. 1, 2013;
  • stabilize payments through 2018, with no cuts for the next 6 years and positive updates to all physicians from 2014 to 2017;
  • provide a higher update for undervalued primary, preventive and coordinated care services; and
  • accelerate development, evaluation and transition to new payment and delivery models put together with input from the medical profession and with external validation.

In a statement, Peter Carmel, MD, president of the American Medical Association, also praised the new legislation.

“The 14 short-term patches Congress has put in place since 2002 to delay, rather than permanently fix, this problem have put patients at risk,” Carmel stated. “There is bipartisan agreement that this formula should be eliminated to ensure access to care for patients, and the time for action is now.”

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