House passes year-long SGR patch, includes California GPCI fix March 27, 2014 Medicare Advocacy, GPCI, Medicare, SGR, Federal Legislation 0 This morning the U.S. House of Representatives passed a year-long patch to stop the Medicare 24 percent sustainable growth rate (SGR) cut on an unusual 30-second voice vote. Unable to come to an agreement on how to fund a permanent repeal of the badly broken formula, despite a bill with bipartisan, bicameral support, Congress appears poised to kick the can down the road for the 17th time in just 10 years. The California Medical Association (CMA) is extremely disappointed that Congress has been unable to find bipartisan funding sources and seize the unprecedented momentum of support for permanent Medicare payment reform. The House bill, “Protecting Access to Medicare Act of 2014” (H.R. 4302), provides a 0.5 percent physician payment update through December 31, 2014, and then a 0 percent update until April 1, 2015. It also includes the California Medicare locality update, known as the California geographic practice cost index (GPCI) fix. The GPCI fix holds rural physicians harmless from cuts permanently. The bill also delays for one year the ICD-10 medical billing coding conversion, until October 15, 2015. Yesterday CMA circulated a letter urging the House to take the time to fund the permanent repeal and pass it rather than adopting another year-long patch. The letter supported the “perseverance of the House and Senate Committees to achieve a bipartisan, bicameral agreement to repeal the flawed Medicare SGR and institute a reasonable new payment system.” The letter also asked the House Speaker Boehner and Senate Leader Reid to return “to the negotiating table and finishing the important work to achieve permanent reform.” Practically speaking, Congress has until April 14 to resolve the remaining differences over the bill’s financing before the 24 percent SGR cut actually takes effect. Preventing the SGR cut is imperative to maintaining patient access to physicians in California. Over 90 national, state and specialty physician organizations called for a no vote on this legislation in the House of Representatives. The one-year patch is expected to cost roughly $20 billion. A significant chunk of that money will be generated through a budget gimmick, extending Medicare sequester cuts beyond the 10-year window used for budget scoring purposes. It is also funded with other physician cuts from misvalued codes and imaging criteria. Some funding came from hospitals and nursing homes. The situation in the Senate is still fluid because new Finance Committee Chairman, Ron Wyden (D-OR), wants a vote on the permanent reform before resorting to a vote on another patch. However, the Senate could vote on a patch before the weekend. Despite the welcome delay in the costly, burdensome ICD-10 coding system and the permanent California GPCI locality update, CMA could NOT support another short-term patch and is still pushing for real reform to the SGR. A short-term patch is no longer acceptable to California physicians. Some have argued that a patch will give Congress more time to negotiate permanent reform, but history informs us otherwise. This latest patch is part of a decade long string of patches that have cost U.S. taxpayers $150 billion, close to the cost of a permanent fix. Moreover, many of the physician funding sources in the current patch legislation could be more cost-effectively applied in a permanent reform bill. To see the bill passed by the House, click here. Contact: Elizabeth McNeil, (800) 786-4262 or ecmneil@cmanet.org. Comments are closed.
