Medicare & Medicaid

How the three SGR repeal bills would change current law

. 2 MIN READ

A new comparison of the three versions of legislation to repeal Medicare’s failed SGR formula reveals how each bill would impact laws in place today and how the proposals compare to one another.

In addition to eliminating the Medicare payment formula that has injected considerable instability into the health care system, each version of the bill includes improvements over current law, reflecting the AMA’s ongoing work to shape the final legislation that will be considered. 

The following provisions are of particular interest:

Updating physician payments. The U.S. House Ways and Means Committee’s version of the legislation includes 0.5 percent annual updates for three years, and the House Energy and Commerce Committee’s bill provides 0.5 percent updates for the remainder of 2014 and in following years. The Senate Finance Committee’s bill does not include automatic annual payment updates.

The AMA continues to advocate for positive payment updates moving forward.

Alignment of Medicare quality reporting programs. Both the Senate Finance Committee and the House Ways and Means Committee’s versions call for consolidating and restructuring current Medicare quality incentive programs as meaningful use of electronic health records, the value-based modifier and the Physician Quality Reporting System. 

Current law puts physicians at risk of several financial penalties if they are unable to meet all of the requirements for these programs—penalties that could add up to double-digit payment cuts. The Senate Finance Committee and House Ways and Means Committee’s bills would limit the overall severity of potential penalties and make bonus payments available to high-performing practices.

Medical liability reforms. Both House versions of the bill include provisions that would limit inappropriate medical liability claims, incorporated from the Standard of Care Protection Act introduced to Congress last year.

While the AMA will continue to advocate for the most beneficial provisions in the final repeal legislation, your lawmakers also need to hear from you. Email your members of Congress today via the AMA’s Fix Medicare Now campaign website to tell them Medicare cannot continue under the SGR formula. 

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