At this time Congress should simply repeal SGR, fund CHIP, fund community health centers and the National Health Service Corps, and refer all other provisions for further study by the appropriate committees.
In the fervor to finally rid us of the flawed SGR model of setting Medicare payment rates, Congress is about to pass legislation (H.R. 1470) that includes ill-advised, misguided and detrimental policies that could cause irreparable harm to our traditional Medicare program. Instead, Congress should revise the current legislation to comply with the following recommendations.
HR 1470, which Congress is scheduled to approve in only two days (March 26), would replace the flawed Sustainable Growth Rate (SGR) method of determining Medicare payments with a new Merit-based Incentive Payment System (MIPS). MIPS introduces considerable administrative complexity which would be a great burden to physicians, but the legislation allows physicians to opt out of MIPS by joining Alternative Payment Models (APMs) such as Accountable Care Organizations (ACOs) or Patient Centered Medical Homes (PCMHs). This RAND study of APMs reveals that physician members of APMs are at very high risk of BURNOUT.
Working Framework of SGR Package House Committees on Energy & Commerce and Ways & Means, March 20, 2015 Repeal and Replace Medicare Physician Payment System. The legislation repeals the flawed SGR formula and replaces it with HR 1470, SGR Repeal and Medicare Provider Payment Modernization Act (replaces SGR with MIPS, the Merit-based Incentive Payment System) […]
Summary of “SGR Repeal and Medicare Provider Payment Modernization Act” House Committees on Energy & Commerce and Ways & Means, March 19, 2015 Summary:http://energycommerce.house.gov/sites/republicans.energycommerce.house.g… Yesterday’s Quote of the Day: http://www.pnhp.org/news/2015/march/emergency-the-mips-stake-is-plunging… Yesterday’s Quote of the Day message sounded the alarm on legislation that would replace the flawed Sustainable Growth Rate formula (SGR) for updating Medicare payments […]
H.R. 1470: “SGR Repeal and Medicare Provider Payment Modernization Act of 2015” 114th Congress A BILL To amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals, and for other purposes. TABLE OF CONTENTS.—The table of contents of this Act is […]
Unions, retirees blast Jerry Brown’s state worker medical plan By Jon Ortiz The Sacramento Bee, March 18, 2015 Unions lined up Wednesday to oppose Gov. Jerry Brown’s proposal to offer high-deductible medical coverage to state employees, suggesting it could hurt workers’ health instead of improving it. “We think that high-deductible plans are a very bad […]
With billions in the bank, Blue Shield of California loses its state tax-exempt status By Chad Terhune Los Angeles Times, March 18, 2015 Authorities have revoked the tax-exempt status of nonprofit Blue Shield of California, potentially putting it on the hook for tens of millions of dollars in state taxes each year. The move by […]
A Boehner-Pelosi prescription for Medicare doc fixes By Jennifer Haberkorn and David Rogers Politico, March 15, 2015 In a rare display of bipartisanship, House leaders are actively pursuing a deal to permanently change the way Medicare pays doctors and to extend a children’s health program for two years. While details are still being ironed out, […]
Consumer Assets and Patient Cost Sharing By Gary Claxton, Matthew Rae, and Nirmita Panchal Kaiser Family Foundation, March 11, 2015 While concerns about cost sharing are not new, the recent coverage expansions under the ACA put a new focus on what it means for coverage to be affordable. The goal of the law was to […]
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