On Thursday, House Republicans released a three-phase framework to permanently repeal the sustainable growth rate formula -- which sets Medicare physician reimbursement rates -- and develop a replacement, MedPage Today reports (Pittman, MedPage Today, 2/7).
Congress routinely has passed legislation to delay cuts called for by the SGR, but physicians face substantial reductions in their Medicare reimbursements each time the "doc fix" expires. The most recent doc fix delayed the cuts until Jan. 1, 2014, at which time physicians face about a 25% reduction to the Medicare reimbursement rates (California Healthline, 2/7).
On Thursday, leaders from the House Energy and Commerce and Ways and Means committees outlined the three phases:
- Repeal the SGR and provide fixed payment rates for a still-to-be-determined period;
- Move away from the current fee-for-service system to one that rewards physicians for quality care; and
- After a number of years, build upon improvements by rewarding efficiency through bonus payments for doctors who deliver efficient care.
Another component of the GOP plan is not to increase the federal deficit, MedPage Today notes. According to new estimates released by the Congressional Budget Office this week, repealing the SGR would cost $138 billion over a decade -- more than $100 billion less than previous estimates. However, an Energy and Commerce aide said the lawmakers have not yet determined offsets for their plan.
The committees are soliciting public comments on the proposal by Feb. 25. However, no time frame for action has been set for after stakeholders submit comments.
Prospects for Bipartisan Compromise
Thursday's proposal is similar to a bill (HR 574) introduced Wednesday by Reps. Joe Heck (R-Nev.) and Allyson Schwartz (D-Pa.). Though both Republicans and Democrats have pledged bipartisan support for the SGR repeal, it is unclear how the two proposals would work together, if at all, MedPage Today notes (MedPage Today, 2/7).
In a statement, Ways and Means Chair Dave Camp (R-Mich.) said, "It is time to bring Medicare into the 21st century." He added, "Achieving that goal will be an all hands on deck effort, and we want all the stakeholders -- doctors, patients and others -- to be a part of that process" (Baker, "Healthwatch," The Hill, 2/7).