Docs would accept payment cuts to force permanent SGR repeal

Senate to vote on temporary fix today; trade groups continue to oppose the patch
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Doctors, opposed to the proposed temporary fix to the sustainable growth rate payment formula (SGR) that is set for a Senate vote this afternoon, told MedPage Today that they would take the 24 percent cut in Medicare payments this year in order to force Congress to decide how to pay for a permanent repeal.

>> UPDATE: Senate approves temporary SGR fix

Physician groups say they are willing to call lawmakers' bluff and would take the deep Medicare cuts under the SGR even though it may force some physician practices to close or stop seeing Medicare patients, according to MedPage Today. They would rather take the hit to force Congress to repeal the much-hated payment formula once and for all.

"We have never opposed a patch before," American College of Physicians spokesman David Kinsman told MedPage Today. "This is unique because we're so close. This time we have bicameral and bipartisan support for permanent reform."

In a move that took the industry by surprise, instead of a permanent repeal, the House late last week approved a one-year delay of the SGR in a bill that also delays the implementation of ICD-10 for a year and postpones compliance with the two-midnight rule and recovery audits of medically unnecessary claims until March 15. Until last week no one publicly discussed adding those measures to the payment formula bill.

The SGR, which determines how much the government pays physicians who treat Medicare patients, has been a thorn in physicians' sides since its implementation in the 1990s. Congress has deployed it only once and typically authorizes annual fixes in its place to prevent the payment cuts. Although lawmakers boasted they reached a bipartisan deal last month to permanently repeal the much-hated formula, it was derailed by a last-minute insertion tying the measure to a delay in the Affordable Care Act's mandate requiring all individuals to obtain health insurance.  

But some say it's likely the Senate will approve the temporary fix in order to figure out howto pay for the permanent repeal, which is estimated to cost as much as $180 billion. The timing of the Senate vote is crucial because the SGR payment cuts will take effect tomorrow unless Congress takes action.

"Suffice it to say that, at least, Congress has made considerable progress in designing a new system to replace the old. It will now sit on a shelf until there is ever the will to agree on the substantial cuts necessary to pay for it," wrote Billy Wynne, founder and CEO of Healthcare Lighthouse, in The Health Care Blog.

To learn more:
- read the MedPage Today article
- read The Health Care Blog post

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