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Conferees Continue Negotiations Late into the Night; Reluctant GOP Reaches SGR Compromise

On Monday, House Republican leaders announced plans to introduce legislation that would extend a middle class payroll tax holiday but not include a solution to Medicare’s sustainable growth-rate formula for physicians; a measure that House Speaker John Boehner (R-OH) deemed necessary due to lack of bipartisan effort from Democrats to discuss payment for the SGR.

With the March 1st deadline for payment cuts still approaching, both parties decided the issue could not be put off any longer. Negotiations resumed, and a resolution was reached: The SGR will be paid for through a combination of bad debt payment cuts, DSH cuts and cuts to health reform’s Prevention and Public Health Fund.

GOP Conferees anticipate push-back from Tea Party members unwilling to vote for a $100 billion payroll tax cut extension without a pay-for, but Speaker Boehner has expressed confidence that he will be able to put together enough support to get the plan through.

NASS Staff Attends Hearing of the House Ways and Means Subcommittee on Health

On February 7th, The House Ways and Means Subcommittee on Health held a hearing to explore avenues to reform the Medicare physician payment sustainable growth rate in an affordable way, and to examine programs that reward physicians who deliver high quality and efficient care.

Witnesses included private payers, a physician organization and a practicing physician; all of whom are engaged in efforts that reward physicians who provide high quality care.

Examples of ways to improve quality included data-driven performance programs, incentives to form physician groups and other payment models.

Chairman Wally Herger said that, if a long term solution cannot be found, the program will go bankrupt.  

President Releases Budget, SGR Fix Included

On Monday, President Obama submitted the 2012 budget to Congress which included the following statement on SGR: “The Administration is committed to working with Congress to achieve permanent, fiscally responsible reform and to give physicians incentives to improve quality and efficiency, while providing them with predictable payments for the care they furnish to Medicare beneficiaries.”

The budget includes a proposed two-year SGR fix for calendar years 2012 and 2013 with the assumption that Congress will find a permanent solution beginning in 2014.  The cost of two-year SGR freeze is approximately $62 Billion; the long-term cost is estimated at $315 Billion over 10 years. All of these projections are based on the assumption that Congress will find the money to pay for solution, which does not exist at this time.