April 2015

After 13 years, 17 patches and countless hours of advocacy effort, Congress finally passed and the President signed legislation to repeal the Medicare Sustainable Growth Rate formula. The bill passed the Senate earlier this week by a vote of 92-8.

Enactment of a permanent SGR fix is a big relief and a big deal – both in the near term and the long term.  In the near term, enactment means physician and other Part B providers will avoid a 21% cut in reimbursements and will instead receive a 0.5% increase in payments for services provided April 1, 2015 or later.  There will be a 0.5% payment update in years 2016-2019.  It also means, CMS will start processing claims it has been holding since April 1 and checks to practices across the U.S. should start flowing.

There are long-term implications as well.  In addition to replacing the SGR formula, the bill also accelerates the transition to Medicare payments based on quality reporting, speeds the adoption of voluntary alternative payment models and makes important changes to CMS's quality incentive and payments systems.

The SGR repeal was a result of a lot of hard work by many physician organizations, including the ATS.  For several years, the ATS leadership has made SGR repeal one of the top policy requests in the annual ATS Hill Day.  ATS leaders and members alike have been in touch with Congress through emails, letters, phone calls and coalition letters about the urgent need to fix the SGR mess.