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Senate finance report describes SGR Repeal Bill

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The Senate Committee on Finance has released a report to accompany S 1871, the “SGR Repeal and Medicare Beneficiary Access Act of 2013.”  The 87-page report states that:

The Committee Bill would permanently repeal the SGR update mechanism and provide zero percent updates until 2023. It also would reform the physician fee schedule by consolidating existing quality programs to place greater focus on value over volume, and encourage participation in alternative payment models (APMs) being tested by the Center for Medicare and Medicaid Innovation (CMMI). After 2023, health care professionals in APMs would receive an annual payment update of two percent; all other professionals would receive an update of one percent.

The Bill would also consolidate the three existing incentive programs into a budget-neutral value-based performance (VBP) incentive program.   Under this program, professionals would receive annual payment increases or decreases based on their performance. By combining the existing quality incentive programs into a comprehensive VBP program, the Committee Bill would further value-based purchasing within the Medicare program while maintaining and improving the efficiency of the underlying structure with which professionals are already familiar.

The three existing incentive programs that would be consolidated in the new VBP incentive program consist of: (1) the Medicare EHR incentive program for meaningful use of certified EHR technology; (2) the physician quality reporting system (PQRS): and, (3) the physician value-based payment modifier.

As described in the Finance Committee report, “The most recent override was approved in December of 2013 as part of the Bipartisan Budget Act of 2013 (BPBA, P.L. 113-67) and replaced the SGR-dictated payment reduction with a 0.5 percent update for three months, until March 31, 2014. If Congress does not act by this date, Medicare professional payment rates will be cut by over 20%.”

The House and Senate are in discussions regarding an SGR replacement, but there are no current plans to bring a bill to the floor of either the House or the Senate.


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