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Historic SGR vote in the House; bill now awaits action by the Senate

The U.S. House of Representatives voted 392-37 earlier today in support of H.R. 2: “The Medicare Access and CHIP Reauthorization Act” (MACRA), which would repeal the flawed sustainable growth rate (SGR) formula. The bill now awaits action from the U.S. Senate, which adjourns for a two-week recess on Friday.

The current SGR patch is set to expire March 31. If the Senate fails to act before its recess, there will be a two-week delay in Medicare payments until Congress returns April 13.

The Society urges physicians to contact U.S. Senators Ron Johnson (R-Wis.) and Tammy Baldwin (D-Wis.) to reinforce the need for SGR repeal now. You can use the American Medical Association’s toll-free Physicians Grassroots Hotline: 800.833.6354 or click here to send an urgent e-mail asking them to support H.R. 2.

“We believe that, while not perfect, this legislation represents years of bipartisan effort to eliminate the seriously flawed SGR formula and implement a new payment and delivery models that will promote high-quality care while reducing costs,” said Society President Richard Dart, MD. “Wisconsin physicians are well positioned to take advantage of this stability, and the new payment and delivery models included in the bill.”

A section-by-section summary of the policy provisions and payfors included in the bill can be found here.

Wisconsin members voting in favor of the bill were U.S Representatives Sean Duffy, Ron Kind, Gwen Moore, Mark Pocan, Reid Ribble, and sponsor of H.R. 2 Rep. Paul Ryan. Wisconsin members voting in opposition were Rep. Glenn Grothman and Rep. Jim Sensenbrenner.

H.R. 2 also included a provision to amend the Qualified Entity (QE) statute to allow for broader sharing of Medicare data. Specifically, this provision would provide flexibility to QEs in the way that they use and share combined Medicare and private claims data with providers, payers and health care consumers. Through these changes, QEs could provide actionable information and targeted analyses to drive positive changes in the health care delivery system. The change to the QE program also would enable QEs to charge a voluntary fee for certain aspects of their work, which creates an important funding stream to further enable their critical transparency and analytics work.

“The Society spent three years working to adjust the QE statute to help improve health care quality and reduce cost through increased transparency,” said Society CEO Rick Abrams. “We are thrilled that the QE provision was included in H.R. 2.”

Also included in the bill was an extension of the work Geographic Practice Cost Index (GPCI) floor that boosts payments for the work component of physician fees in areas where labor cost is lower than the national average. The provision extends the existing 1.0 floor on the “physician work” cost index until Jan. 1, 2018.

“We believe that H.R. 2 takes a balanced approach that promotes the long-term sustainability of the Medicare program and will stabilize the Medicare program for our nation’s seniors and physicians,” said Dr. Dart. “Please take a moment to also thank your member of Congress for their vote in favor of this historic legislation.”

For contact information for your U.S. Representative, click here.

Back to March 26, 2015 Medigram