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Senate passes SGR repeal

April 15, 2015
by Lois A. Bowers, Senior Editor
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Update: President Barack Obama signed H.R. 2 into law on April 16.

The U.S. Senate last night voted to repeal permanently the sustainable growth rate (SGR) formula under which physicians have been reimbursed for care they provide through Medicare. The formula has been in place since 1997.

To rewatch the vote, visit C-Span's website.

The April 14 vote on the “doc fix” bill, formally known as H.R. 2 or the Medicare Access and CHIP Reauthorization Act of 2015, was 92–8 and followed 392–37 passage in the House March 26. President Barack Obama has indicated that he will sign the legislation.

“This is a historic day in Washington,” Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, said in a statement. “The Senate’s bipartisan effort to pass H.R. 2 is a proud moment for our country and will impact millions of patients, families and providers in a truly positive way. This legislation is the first step in establishing long-term stability to the profession. The next step includes a continued bipartisan effort in other important areas, such as thoughtful payment reform. We look forward to continuing our important work with Congress and delivering even more solutions for quality care.”

Cheryl Phillips, LeadingAge’s senior vice president for public policy and advocacy, said: “LeadingAge members and advocates played a critical role in pushing the ‘doc fix’ bill over the finish line. From meeting with 270 congressional offices during our PEAK Leadership Summit last month to sending more than 2,000 letters to Capitol Hill, LeadingAge members sent a clear message to lawmakers: Take the  ‘doc fix’ bull by the horns, and permanently solve the problem in a bipartisan way.”

Therapy caps

Phillips added that LeadingAge will continue to remain active on the Medicare issues important to its members, including permanently repealing therapy caps and eliminating observation stays. An amendment that would have repealed a cap on the amount of therapy services Medicare beneficiaries can receive failed in the Senate by a 58–42 vote last night; 60 “yes” votes were needed for passage. Five other amendments failed as well.

AARP CEO Jo Ann Jenkins said the SGR repeal was much-needed but that the group “was disappointed that the bipartisan Cardin–Vitter amendment to remove Medicare’s arbitrary cap on physical therapy, speech-language pathology and occupational therapy services was not included. Many Medicare patients, particularly stroke victims and people with Parkinson’s and multiple sclerosis, would have benefitted.” Buoyed by the amendment’s approval by many senators, Jenkins said her group would continue to work toward the elimination of the caps.

Of cuts and costs

The Senate’s passage of H.R. 2 avoids a 21 percent pay cut that was to be imposed on Medicare physicians beginning April 1, although the Centers for Medicare & Medicaid Services had delayed the processing of claims while awaiting the outcome of the vote. The legislation changes the way physicians are compensated, moving toward quality of care rather than volume. Doctors will receive an 0.5 percent increase in pay in each of the next five years as the transition occurs. The Congressional Budget Office estimates that the bill will add $141 billion to the federal deficit; its changes will cost $210 billion, $70 billion of which will come from Medicare beneficiaries and providers.

Naushira Pandya, MD, CMD, president of AMDA–The Society for Post-Acute and Long-Term Care Medicine, said: “We thank Congress for coming together and passing this vital legislation that will reward post-acute and long-term care (PA/LTC) practitioners for the level of quality care they provide for some of the most medically complex and vulnerable individuals in our country. The monies appropriated in the legislation will help us develop meaningful and appropriate quality measures for the PA/LTC setting. We look forward to our continued work with Congress, federal agencies and other stakeholders.”