After lawmakers derailed what looked like a permanent legislative fix to the widely unpopular sustainable growth rate (SGR) formula last year, Congress members plan to craft another long-term fix ahead of a looming deadline, MedPageToday reports--and this time they just might pull it off.
The leader of the House Ways and Means and Energy committees are involved in active discussions to try to "achieve an effective permanent resolution to the SGR problem, strengthen Medicare for our seniors, and extend the popular Children's Health Insurance Program," the committees said in a joint statement last week.
The SGR patch Congress approved in 2014 will expire March 31, after which physicians face a 21.2 percent cut to their Medicare reimbursements. The negotiation process is a familiar one, but this time, House Minority Leader Nancy Pelosi (D-Calif.) and House Speaker John Boehner (R-Ohio) are actively discussing how to fund the repeal, according to Vox. Repealing the SGR permanently this year would cost $177 billion; rather than tackle the entire cost at once, current negotiations involve roughly $70 billion in spending cuts with the balance attached to the deficit. The cuts would involve a combination of slower growth in post-acute care reimbursement; small reimbursement cuts for hospitals; cost-shifting to seniors in MediGap plans; and a premium hike for wealthy Medicare beneficiaries.
Despite the potential cuts, providers overwhelmingly support SGR repeal, as more than 750 physician groups urged Congress to pass a permanent fix in a letter to House and Senate leaders. "We made significant progress in the previous Congress to find common ground for a Medicare fix that would establish a clear pathway for developing and implementing new healthcare delivery and payment models that improve quality, coordinate care and reduce costs," Robert M. Wah, M.D., president of the American Medical Association, wrote. "It would be a shame to once again let that solution, which took months to develop, go to waste."