Advertisement
Advertisement
March 31, 2014
Congress Passes One-Year Patch for Medicare SGR and ICD-10 Implementation Delay
March 31, 2014—The American Medical Association (AMA) advised in the AMA Wire that the US Senate has passed a $21 billion patch to the Centers for Medicare & Medicaid Services Sustainable Growth Rate (SGR) formula for Medicare payments.
As reported in the AMA Wire, the Senate vote of 64 to 35, which followed passage in the US House of Representatives last week, took place on the eve of an SGR-imposed payment cut of 24%. The patch will extend the current 0.5% update through the end of the year and freeze payment rates from January to March of next year.
On March 27, the AMA stated that the House used a legislative tactic that was characterized as “trickery” to pass the Medicare payment patch. Originally scheduled for that morning, the vote was delayed procedurally because the House did not have a quorum. Instead, House leaders from both parties agreed to take a voice vote before the majority of representatives could make it to the floor.
The AMA noted that, despite some positive provisions included in the bill, physician groups have pointed to the greater overall loss as Congress defaulted to a temporary patch even when an unprecedented bipartisan legislative policy for repealing the SGR formula was at last on the table.
As summarized in the AMA Wire, the bill also includes the following other revisions and extenders:
• The Secretary of the US Department of Health and Human Services will be permitted to continue the suspension of postpayment audits by Medicare retrospective audit contractors through June 2015.
• The Medicare sequester cuts will be revised in 2024 to increase their impact, saving the federal government an estimated $4.9 billion at physicians’ expense.
• Implementation of the ICD-10 code set would be delayed 12 months until October 1, 2015. Transitioning to the new code set will be extremely costly for physicians, and the AMA continues to work to stop its implementation altogether.
AMA President Ardis Dee Hoven, MD, released the following statement:
The AMA is deeply disappointed by the Senate's decision to enact a 17th patch to fix the flawed SGR formula. Congress has spent more taxpayer money on temporary patches than it would cost to solve the problem for good.
This bill perpetuates an environment of uncertainty for physicians, making it harder for them to implement new innovative systems to better coordinate care and improve quality of care for patients.
Remarkable progress was made this past year in reaching a bipartisan, bicameral agreement on policy to repeal the SGR, and the AMA encourages Congress to continue its work and resolve outstanding issues. On behalf of Medicare patients and physicians across the country, it is critical that we achieve permanent Medicare physician payment reform.
We will continue our efforts to secure a permanent SGR repeal this year.
In February 2014, the AMA announced that new joint legislation to repeal the Centers for Medicare & Medicaid Services’ “failed” SGR formula is advancing to both chambers of Congress after an agreement announced by the three committees that put forth repeal bills earlier this session. The bill is titled SGR Repeal and Medicare Provider Payment Modernization Act of 2014.
Advertisement
Advertisement
