SGR Update: House passes one-year Medicare pay patch

Friday, March 28, 2014 07:43 AM

Yesterday, Thursday, March 27, the U.S. House of Representatives passed by voice vote yet another short-term Medicare payment patch. The American Medical Association urged legislators to vote against the bill, saying it gives up a real opportunity to solve the SGR problem now and makes it more difficult to do so in the future. The measure now moves to the Senate.

If passed there, the Protecting Access to Medicare Act of 2014 would be Congress’ 17th temporary Medicare patch. It extends the current 0.5 percent update through the end of the year and freezes payment rates from January to March of next year, averting the 24 percent cut to physician payments that would have gone into effect on Tuesday, April 1. The bill also delays the implementation of the ICD-10 code set until at least Oct. 1, 2015.

The AMA and other physician groups have lobbied for permanent repeal of the failed sustainable growth rate (SGR) formula for the past decade and, over the past few months, had advocated for lawmakers to pass another bill, H.R. 4015/S. 2000, that contained a repeal and other payment reform measures. All Colorado representatives and both senators expressed support for repeal of Medicare’s Sustainable Growth Rate, with two committing to co-sponsor H.R. 4015. (Click here to see if your representative is a co-sponsor.) But the cost of that plan was about $140 billion over 10 years and lawmakers haven’t been able to agree on how to pay for it.

“By extending the Medicare provider sequester and ‘cherry picking’ a number of cost savings provisions included in the bipartisan, bicameral framework, the Protecting Access to Medicare Act actually undermines future passage of the permanent repeal framework,” AMA President Ardis Dee Hoven, MD, said in a statement Wednesday.

“Further, it would perpetuate the program instability that now impedes the development and adoption of health care delivery and payment innovation that can improve health care and strengthen the Medicare program,” she continued. “Full repeal of the SGR is the answer to strengthening the Medicare program, not another patch.”