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CBO Analysis Renews Calls for SGR Repeal

John Commins, for HealthLeaders Media, February 7, 2013

On Wednesday, U.S. Reps. Allyson Schwartz (D-PA) and Joe Heck, DO (R-NV) filed the Medicare Physician Payment Innovation Act to repeal the SGR and to create what they called "a clear path toward comprehensive reforms of Medicare payment and delivery systems."

"There is no single greater threat to the long-term solvency of Medicare and seniors access to healthcare than the broken Medicare payment system, or SGR. Each year, healthcare practitioners are faced with devastating cuts that could make it nearly impossible for them to continue providing care for Medicare beneficiaries. And each year Congress has avoided coming up with a serious solution to this problem," Heck said in a media release touting the bill.

"This bill is that solution. Our seniors and their healthcare providers deserve a program that is immune to Congressional dysfunction and that would provide stability by replacing the currently flawed formula with a system that promotes efficient, cost-effective healthcare."

The bill would:

  • Permanently repeal the SGR formula.
  • Provide annual positive payment updates for all physicians for four years.
  • Ensure access to preventive care, care coordination, and primary care services through increased payment updates for those services.
  • Aggressively test and evaluate new payment and delivery models.
  • Identify payment models to provide options for providers across medical specialties, practice types, and geographic regions.
  • Stabilize payment rates for providers who demonstrate a commitment to quality and efficiency within a fee-for-service model.
  • Ensure long-term stability in the Medicare physician payment system through predictable updates that accurately reflect the cost and value of providing health care services in coordinated care models.
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