Congress likely gridlocked on SGR fix

The need to pass another temporary fix to the sustainable growth rate (SGR) formula is looming, and the options could force Congress to delay its holiday recess--or encounter a political stalemate, reports Politico.

Physicians who take Medicare patients are slated to have their payments reduced 27.4 percent starting Jan. 1. However, the physicians rarely have faced payment cuts under SGR. Congress has repeatedly passed legislation to stave off such steep cuts in the past.

In the meantime, the Republican-controlled House of Representatives has recommended a 1 percent rate hike for physicians in 2012 and 2013--in lieu of up to $17 billion in cuts to hospital funding over the next decade, notes AHA News Now. The proposed reductions would affect services such as outpatient evaluations and management services.

Should Congress not put off its recess, the Centers for Medicare & Medicaid Services could temporarily delay payments to physicians after Jan. 1 until legislation fixing SGR is passed and signed into law.

"It's definitely a nightmare," said former CMS Administrator Tom Scully, who briefly delayed payments to doctors in 2003. "Docs don't get paid, and CMS gets millions and millions of claims backed up," he told Politico.

For more information:
- read the Politico article
- read the AHA News Now article