New SGR repeal proposal on the way

April 5, 2013

A new proposal for repealing Medicare’s sustainable growth rate formula is incubating in the U.S. House of Representatives, and its authors are seeking comments on it from doctors and other health professionals.

A new proposal for repealing Medicare’s sustainable growth rate (SGR) formula is incubating in the U.S. House of Representatives, and its authors are seeking comments on it from doctors and other health professionals.

Last week, the chairs of the powerful House Committee on Ways and Means and Committee on Energy and Commerce, along with the chairs of their respective subcommittees on health, issued the second draft of their “SGR Repeal and Reform Proposal” and invited input from stakeholders. The deadline for submitting comments is April 15.

The proposal calls for:

  • repealing the SGR, thereby eliminating the 24.4% across-the-board cut in Medicare reimbursements;

  • establishing a period of stable payments, thereby enabling providers to prepare for payment changes;

  • engaging providers in efforts to improve, reform, and update reimbursement systems;

  • empowering providers and other relevant stakeholders to determine the measures of quality and efficiency that are meaningful for Medicare beneficiaries;

  • establishing a more reasonable timeframe for developing measures that promote value;

  • prompting the Centers for Medicare and Medicaid Services to provide timely feedback so that providers an make adjustments to improve patient care and optimize incentive payments;

  • providing options for providers to select the Medicare payment system that best fits their practice situation; and

  • reducing practice costs and administrative burdens so that providers can focus on patient care.

The committees released a first draft of their joint proposal in February. The latest iteration is more detailed and reflects many of the comments they received on the first draft. Among those comments were a need for a period of stable payments to allow time for alternate payment models to evolve, a desire for evidence-based quality and efficiency measures, and a need for timely performance feedback hat allows providers to identify improvement opportunities and optimize inventive payments.

In their introduction to the revised proposal, the chairs state that fixing the SGR is a “top priority” for their committees. “We recognize that the uncertainty over potentially devastating reimbursement cuts makes it difficult for practices to plan for the future. This uncertainty affects decisions to hire necessary and staff and make investments in practice improvement,” they add.

Comments can be e-mailed to sgrcomments@mail.house.gov. View the full proposal at http://energycommerce.house.gov/sites/republicans.energycommerce.house.gov/files/analysis/20130403SGR.pdf.