House and Senate Pass 3-Month SGR Patch

The House and Senate have both approved legislation adopting a 3-month SGR patch.  This patch will prevent the SGR related cut in provider payments from occurring on January 1, 2014 and it would also provide a 0.5% increase in the Conversion Factor.  The President has said he will sign this legislation.

But beyond that headline, the 3-month SGR patch, designed to forestall cuts above 20% to make up for years of shortfalls, includes a provision to keep in place—possibly until 2021—the 2% cuts to Medicare’s reimbursement that were imposed earlier this year due to the sequester.

Break Away from the Static

Permanent repeal of the SGR formula would add approximately $116 billion in additional outlays from the Medicare Trust Fund over the next 10 years.  Neither the House nor the Senate Committees disclosed how they intend to “pay for” this SGR fix legislation.  Some combination of Medicare cuts elsewhere in the program (I think we know what this means) or revenue increases will have to be adopted in conjunction with the long-term “fix” in order to account for the additional spending.

As always, ADVOCATE will keep you updated as more details about the 2014 fee schedule and all issues impacting radiology become available.

Best regards,
Kirk Reinitz, CPA