Republican leaders recently released an updated draft plan to permanently repeal and replace the sustainable growth rate (SGR) formula, which sets the Medicare physician payment rates. The draft was developed by House Energy and Commerce Committee Chair Fred Upton (R-Mich.), Ways and Means Committee Chair Dave Camp (R-Mich.) and the committees’ health subcommittee chairs, Reps. Kevin Brady (R-Texas) and Joe Pitts (R-Pa.).
Congress has passed legislation annually to delay the SGR cuts, but physicians face substantial reductions in their Medicare reimbursements each time the “doc fix” expires. The most recent doc fix delayed the cuts until January 1, 2014, at which time a 25% reduction to the Medicare reimbursement rates will be enacted.
The proposal includes three phases:
- Repeal the SGR and provide fixed payment rates for a still-to-be-determined period;
- Move away from the current fee-for-service system to one that rewards physicians for quality care; and
- After a number of years, build upon improvements by rewarding efficiency through bonus payments for doctors who deliver efficient care.
The American Medical Association, American Medical Group Association and Medical Group Management Association have applauded the new plan.