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SGR Repeal Bill Advances to Full House Committee

Margaret Dick Tocknell, for HealthLeaders Media, July 24, 2013

Rewarding performance
Beginning in 2019, physicians receiving fee-for-service reimbursement will receive an additional update adjustment based on quality performance under the update incentive program (UIP). Performance will be assessed based on quality measures and clinical practice improvement.

Providers and other stakeholders will have a say in the development and selection of the UIP quality measures. High-performing providers will have the opportunity to earn a 1% bonus payment, while low performing providers will see a 1% reduction in payments.

Alternative payment models
Beginning in 2015, providers and other stakeholders may submit proposals for new payment models to an independent entity that will review proposals and make recommendations to the Department of Health and Human Services for models to move forward as either a demonstrations or permanent programs.

Care coordination and patient-centered medical homes
The bill establishes new payment codes for complex chronic care management. The legislation also ensures that Medicare payment is available for care coordination services performed by physicians who are certified as a level III medical home by the National Committee on Quality Assurance, recognized as a patient-centered specialty practice by the National Committee on Quality Assurance, and have received equivalent certification or meet other comparable qualifications.

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1 comments on "SGR Repeal Bill Advances to Full House Committee"


Matthew Taber (7/24/2013 at 11:59 AM)
Multiple attempts to repeal the SGR have failed miserably in the past. Proponents of the repeal completely had the opportunity to [INVALID] a repeal into the Fiscal Cliff legislation that passed with flying colors January 1st but proponents must have been too busy partying over New Years because they failed to [INVALID] the repeal into the legislation. Having worked for a member of the House in the past and worked on healthcare policy on the U.S. Senate HELP Committee, I understand exactly what it takes to get legislation passed. In order for this bill to pass, it will have to have all 20 physicians in Congress vote for it. In addition, it will need the votes of the fiscally conservative Blue Dog Democrats, Nancy Pelosi, John Boehner, Steny Hoyer, Harry Reid, Mitch McConnell, Mike Enzi, Lamar Alexander, Max Baucus, and Dick Durbin. Physicians and practice managers should lobby these individuals directly (very easy to do as I do it on a daily basis) if they wish to see the SGR be repealed.