Improve the health of the people of Wisconsin by supporting and strengthening physicians' ability to practice high-quality patient care in a changing environment.

House committee votes to repeal SGR, allow access to Medicare data

In a rare vote of bipartisanship in Washington, DC, the House Energy and Commerce Committee voted 51-0 Wednesday to approve a bill that repeals Medicare’s Sustainable Growth Rate (SGR) formula. Society CEO Rick Abrams and Director of State and Federal Relations Chris Mambu Rasch were at the meeting when the committee voted on the bill, which included language on access to Medicare data.

The Wisconsin Medical Society, American Medical Association (AMA) and dozens of other organizations have pressed Congress to find a permanent solution to the flawed SGR rather than the temporary fixes made since 2003. Under the current SGR formula, physicians would face a payment cut of about 25 percent in January 2014.

The Energy and Commerce Committee’s proposal would replace SGR cuts with annual payment increases of 0.5 percent from 2014 through 2018. Starting in 2019, the current system would be replaced with a fee-for-service model that includes incentives. Physicians would be able to opt-out of the fee-for-service system at any time and select alternative payment models such as patient-centered medical homes, specialty care models and bundled payments.

An amendment to the bill included language on access to Medicare data that the Society and many Wisconsin health care stakeholders have worked diligently to obtain. The amendment mirrors the language the Society suggested and would allow qualified entities (QEs) such as the Wisconsin Health Information Organization (WHIO) to provide downstream access to Medicare data to its subscribers, including the Society. The amendment also created further flexibility and appropriate limitations for non-public use of Medicare claims data but kept more stringent safeguards for public use of the data.

The Society thanks the AMA for its endorsement of the Society’s Medicare data language and its efforts to ensure that it was included in the amendment. The Society will continue to push for its inclusion as the House Ways and Means Committee and Senate Finance Committee take their turn at a SGR repeal bill in September and early fall. A summary of the proposal is on the House Energy and Commerce Committee’s website.

Back to August 1, 2013 Medigram