House Energy Committee Advances Bill to Reform Medicare Physician Payments

The House Energy and Commerce Committee voted 51-0 to advance H.R. 2810, the Medicare Patient Access and Quality Improvement Act, to repeal the broken sustainable growth rate formula (SGR) and replace it with a system that provides physicians with the certainty that they need to run their practices. HR 2810 is likely to be used as a framework by the House Ways and Means Committee for developing more comprehensive SGR legislation, according to Ted Burnes, director of RADPAC.

“The time of temporary patches and kicking the can down the road is over. For more than two years, this committee has worked to develop a reform policy to repeal the SGR, and the discussion draft before us today, sponsored by Dr. Burgess, is the first meaningful product to do so since SGR was created in the Balanced Budget Act of 1997,” said Health Subcommittee Chairman Joe Pitts (R-PA).

“If the SGR goes into effect, it would mean providers would face a 25% cut in Medicare reimbursement.” said Health Subcommittee Vice Chairman Michael C. Burgess, M.D. (R-TX), lead sponsor of the legislation.

Break Away from the Static

The bill also included the requirement that the Centers for Medicare and Medicaid Services (CMS) provide data justifying the multiple procedure payment reduction (MPPR) implemented in 2012 and expanded in 2013. “The Secretary of Health and Human Services shall make publicly available the data used to establish the multiple procedure payment reduction policy to the professional component of imaging services in the final rule published in the Federal Register.”

“The MPPR portion of the bill has bipartisan support and is budget-neutral, which makes it difficult to get rid of,” he notes. “It is our hope that in asking CMS to justify the 25% cut, we will establish a platform for future discussion with them regarding a more appropriate payment reduction for multiple procedures based on our understanding of the potential efficiencies.”

ADVOCATE will continue to provide updates as information becomes available.

Best Regards,
Kirk Reinitz, CPA