Congress tries to wrangle another SGR fix

By Kate Madden Yee, staff writer

November 18, 2010 -- Senate Majority Leader Harry Reid (D-NV) is expected to ask for unanimous consent for a bill that would institute a 31-day payment fix to the Medicare sustainable growth rate (SGR) formula, freezing current rates and temporarily averting a 23% cut to physician payments currently set for December 1, 2010, according to the American College of Radiology (ACR) in Reston, VA.

The "Physician Payment and Therapy Relief Act of 2010" would extend the 2.2% update that expires on November 30 through December 31, and would cost $1 billion; it appears that Congress is also trying to work up a longer, 12-month reprieve, estimated to cost approximately $16 to $17 billion, according to Pam Kassing, ACR's senior director of health economics and policy.

"This [attempt to fix the SGR formula] could be delayed into mid-December, although Congress will probably work something out before the Christmas holiday," Kassing told "It's all still very fluid."

The House will adjourn for Thanksgiving on November 18 and will not be back in session until November 29, Kassing said. Even if the Senate moves on the issue it will remain in limbo until then.

Congress' challenge will be to pass this 12-month fix with acceptable solutions for how to pay for it, according to Kassing. One way to do this would be to attach the SGR fix to the larger tax package extending the expiring tax extenders and tax cuts instituted under President George W. Bush, she said.

This new attempt to put off the physician payment cuts is just the latest in a series that most recently culminated in President Barack Obama signing legislation in June that reversed a 21% cut in Medicare payments to doctors under the SGR formula, delaying until November 30 the cut in the Medicare Physician Fee Schedule (MPFS) mandated by the formula and, in fact, raising physician payments by 2.2%.

Earlier this month, the bipartisan National Commission on Fiscal Responsibility and Reform submitted a proposal that would eliminate the SGR and lower physician pay incrementally over the next 10 years, in addition to cutting federal spending and reducing the federal deficit.

If Congress once again is not able to push this new reprieve through, the 2.2% increase will be rescinded December 1 and the 21% SGR cut will take effect, a cut that will then be followed by another cut in the MPFS conversion factor slated to take effect on January 1, 2011.

By Kate Madden Yee staff writer
November 18, 2010

Obama signs SGR fix after House passes 6-month delay, June 25, 2010

House holds SGR fix hostage to jobs bill, June 22, 2010

CMS begins paying claims at lower SGR rate, June 21, 2010

Senate delays Medicare cuts until December, June 18, 2010

Senate committee takes SGR action, June 18, 2010

Copyright © 2010


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