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Home > Physician payment bill advances through House committee

Physician payment bill advances through House committee

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August 02, 2013 | Mary Mosquera - Contributing Editor

The House Energy and Commerce Committee on July 31 approved legislation to repeal and replace the sustainable growth rate (SGR) formula, moving another step closer to a more stable Medicare physician payment system based on delivering quality and efficient care instead of 11th-hour fixes.

The bill moves to consideration by the full House of Representatives. Meanwhile, Congress adjourns Aug. 2 for its annual recess and won’t be back to work until Sept. 6.

[See also: Latest 'doc fix' moving forward [3]]

The Energy and Commerce Committee voted [4] 51-0 to advance the Medicare Patient Access and Quality Improvement Act, H.R. 2810, but it still does not contain a funding method. Rep. Fred Upton (R-Mich.), committee chairman, said in a statement that the bipartisan supporters “…are all resolved to achieve reform in a fiscally responsible manner.”

Congress has repeatedly prevented Medicare reimbursement rate cuts under SGR from taking effect with a temporary “doc fix.” But there is no certainty that this legislation might become law in time to avert a 25 percent cut in physician payments that will drop in January when the latest temporary measure expires.

The 72-page bill [5] preserves an enhanced fee-for-service, repeals the SGR and provides for a period of payment transition. The vote out of committee was “…yet another important step forward in an extremely collaborative and transparent process,” said Rep. Michael Burgess (R-Tex.), a physician and lead sponsor of the legislation, in a statement.

The new system would roll out in phases. First, Medicare would increase payments 0.5 percent annually from 2014 through 2018 as providers transition to reporting of quality measures.

[See also: Another crack at SGR [6]]

In 2019, physicians practicing in fee-for-service would receive an additional 1 percent bonus based on performing quality measures and clinical practice improvements through an updated incentive program. The payments of low performing physicians would be decreased 1 percent.

Providers may leave the fee-for-service system and opt instead for alternative payment models, including patient-centered medical homes, accountable care models, bundled payments for episodes of care, or a transparent process toward another model.

The Congressional Budget Office has estimated the cost of repealing the SGR at about $138 billion over 10 years. H.R. 2810 provides for $100 million being used from the Medicare Federal Supplementary Medical Insurance Trust Fund to help pay for the infrastructure needed and $1 million annually toward provider incentives.

The Bipartisan Policy Center said that not only was the committee developing a long-term payment system but using it to improve quality, value and care coordination in Medicare. However, Katherine Hayes, the center’s director of health policy, said in a statement that lawmakers need to continue their bipartisanship as the bill moves to the House floor, “particularly as potentially contentious policies are added to offset the costs of the bill.”
 

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Mary Mosquera
Senior Editor for Government Health IT [8]
Follow Mary on Twitter [7] @GovHITreporter [7]

Source URL: http://physbiztech.com/news/business/physician-payment-bill-advances-through-house-committee

Links:
[1] http://physbiztech.com/forward?path=node/14166
[2] http://physbiztech.com/print/14166
[3] http://www.healthcarefinancenews.com/news/house-panel-advances-bill-repeal-sgr
[4] http://energycommerce.house.gov/markup/markup-hr-2810-medicare-patient-access-and-quality-improvement-act-2013-and-hr-2844-federal
[5] http://www.gpo.gov/fdsys/pkg/BILLS-113hr2810ih/pdf/BILLS-113hr2810ih.pdf
[6] http://www.healthcarefinancenews.com/news/another-crack-sgr
[7] http://www.twitter.com/GovHITreporter
[8] http://www.govhealthit.com