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SGR Formula is Repealed

On Tuesday, April 14, the United States Senate voted overwhelmingly to repeal Medicare’s sustainable growth-rate formula used to determine physician reimbursement. The vote passes legislation approved by the House of Representatives in late March.

Approved by a margin of 92-8, the vote holds off a planned 21.2% cut in payments just one day before CMS was to begin processing claims at the reduced rate. The legislation is expected to be signed by President Obama, ending the cycle of 17 consecutive short-term fixes.

The bill, known as the Medicare Access and CHIP Reauthorization Act of 2015, replaces the SGR with an increase of 0.5% in Medicare physician reimbursement starting in July 2015 through December 2015, then annual 0.5% increases through 2019.

The package introduces a new two-track payment system for doctors designed to move more of their patients toward risk-based payment models. Physicians that qualify for the alternative track will receive higher reimbursement rates beginning in 2019.

To read additional news coverage of the SGR repeal visit:

Modern Healthcare article (April 15, 2015)

MedPage Today (April 15, 2015)

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