Medicare & Medicaid

Casting aside reform bill, Congress passes another Medicare patch

. 2 MIN READ

The U.S. Senate Monday evening voted in favor of yet another temporary measure in a long line of Medicare payment patches, casting aside broadly supported legislative policy that instead would have reformed the Medicare payment update system.

“The AMA is deeply disappointed by the Senate’s decision to enact a 17th patch to fix the flawed sustainable growth rate (SGR) formula,” AMA President Ardis Dee Hoven, MD, said in a statement following the vote. “Congress has spent more taxpayer money on temporary patches than it would cost to solve the problem for good.”

The $21 billion patch was passed in a vote of 64 to 35, which took place on the eve of an SGR-imposed payment cut of 24 percent. The patch will extend the current 0.5 percent update through the end of the year and freeze payment rates from January to March of next year. 

“This bill perpetuates an environment of uncertainty for physicians, making it harder for them to implement new innovative systems to better coordinate care and improve quality of care for patients,” Dr. Hoven said.

Also included in the bill are a variety of other revisions and “extenders,” including:

  • The secretary of the U.S. Department of Health and Human Services will be permitted to continue the suspension of post-payment audits by Medicare retrospective audit contractors through June 2015.
  • The Medicare sequester cuts will be revised in 2024 to increase their impact, saving the federal government an estimated $4.9 billion at physicians’ expense.
  • Implementation of the ICD-10 code set would be delayed 12 months until Oct. 1, 2015. Transitioning to the new code set will be extremely costly for physicians, and the AMA continues to work to stop its implementation altogether.

Despite some positive provisions included in the bill, physician groups have pointed to the greater overall loss as Congress defaulted to a temporary patch even when an unprecedented bipartisan legislative policy for repealing the SGR formula was at last on the table.

“Remarkable progress was made this past year in reaching a bipartisan, bicameral agreement on policy to repeal the SGR, and the AMA encourages Congress to continue its work and resolve outstanding issues,” Dr. Hoven said. “On behalf of Medicare patients and physicians across the country, it is critical that we achieve permanent Medicare physician payment reform.”

The AMA will continue to press Congress to pass permanent SGR repeal this year.

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