The Society of Interventional Radiology (SIR) said that language added to fix the sustainable growth rate calculation (SGR) in the U.S. House of Representatives Children’s Health and Medicare Protection Act of 2007 (CHAMP) is estimated to result in a 40% decrease in reimbursement for all minimally invasive procedures over the next 10 years. The SGR is the method used for calculating physician reimbursement for Medicare.
The Fairfax, Va.-based SIR said it supports the cause of extending and expanding funding for indigent children; however, the SGR legislation tacked onto the CHAMP Act will cause a loss of access to Medicare beneficiaries to many types of invasive therapies, according to the society.
The legislation divides physician services into different categories - and thus physicians; enacting six different conversion factors based on these categories or "buckets". The proposed buckets and projected changes in reimbursement (not including an adjustment for inflation) are as follows:
- 1 Primary and preventive, 49 percent
- 2 Other E/M, -5 percent
- 3 Surgery, 8 percent (includes only 10-day and 90-day major surgery)
- 4 Other procedures, -21 percent (includes all 0-day global, minimally invasive surgeries)
- 5 Anesthesia, 37 percent
- 6 Imaging, -21 percent
SIR noted that with adjustment for inflation, both "other procedures" and "imaging" are expected to result in a 40 percent decrease in reimbursement for these buckets.
The society said it strongly supports providing healthcare treatment to indigent children, which was the sole focus of the Senate version of this legislation; it does not support the House's version because of the inclusion of the short-sighted "fix" to the SGR problem.
SIR urged physicians and facilities affected by the proposed SGR re-allocation to contact their House representative to express their opposition to the legislation, as currently drafted. Further information is available at the SIR Web site at http://www.sirweb.org/.