259 Congressional representatives call for SGR reform

November 25, 2013

A majority of the U.S. House of Representatives have signed a letter urging House leadership to support repeal of the Sustainable Growth Rate (SGR) formula, a long-time revenue threat to physicians.

A majority of the U.S. House of Representatives have signed a letter urging House leadership to support repeal of the Sustainable Growth Rate (SGR) formula, a long-time revenue threat to physicians.

The November 20, 2013, letter from 259 Congressional members to Speaker of the House Rep. John Boehner and Minority Leader Rep. Nancy Pelosi says the time is now to do away with SGR.

“We should not pass up this chance to repeal the SGR-with fiscally responsible offsets-and enact a permanent solution,” the letter reads. “This year represents a great opportunity to repeal the flawed SGR formula, reform healthcare delivery to drive quality and efficiency, and set Medicare on a more stable and predictable course for current and future generations of patients and physicians.”

The SGR formula was created in the 1990s to help contain the growth in healthcare spending, but instead has called for drastic cuts in physician payments each year, requiring Congress to step in at the last moment and override the cuts. The proposal would cost about $139 billion. In the last 10 years, Congress has spent $146 billion on short-term SGR fixes.

The latest reform efforts calls for freezing payment levels through 2023 and creating a value-based performance (VBP) payment program in 2017. Creation of the VBP also would end reimbursement penalties under the Physician Quality Reporting System, Value-Based Payment Modifier and Meaningful Use penalties at the end of 2016, according to a discussion draft prepared by the House Ways and Means Committee and the Senate Finance Committee, Democratic and Republican leaders in both committees are preparing the plan, dubbed the “SGR Repeal and Reform Proposal.”

Groups such as the American Medical Association (AMA), the American College of Physicians (ACP), and the American Academy of Family Physicians (AAFP) have all said they are encouraged by the latest proposal.