It came down to the wire, but late Tuesday night the Senate passed a bill that would repeal the Medicare sustainable growth rate (SGR) formula by a vote of 92-8. The historic vote sent the bill to President Obama and will finally end a series of temporary fixes that annually threatened physician payments.
The $214 billion bill replaces the current SGR with annual 0.5 percent payment updates through 2019. At that point, individual physicians would have the opportunity to earn incentive payments through either an Alternative Payment Model (APM) program or the newly devised Merit-Based Incentive Payment System (MIPS).
The bill also includes a means testing component to help offset costs and a two-year extension of the Children’s Health Insurance Program (CHIP).
Had the Senate failed to vote or shot down the bill, physicians were scheduled to see more than 21 percent cut from Medicare claims payments beginning Wednesday. Last year’s temporary SGR patch actually expired April 1, but a 14-day claims processing window bought time while the Senate went on a two-week recess.
The drama late Tuesday stemmed not only from whether the overall bill would pass, but also over votes on a series of six amendments which would have sent the bill back to the House had any of them passed. The amendments included measures from Republicans to repeal the Affordable Care Act’s individual mandate, strike an exemption to the pay-as-you-go rules included in the bill, and remove the APM and MIPS incentives. Democrats put forth amendments to extend CHIP for four years, eliminate annual cost caps on outpatient therapy for Medicare beneficiaries, and lift abortion restrictions on community health centers.
“Passage of this historic legislation finally brings an end to an era of uncertainty for Medicare beneficiaries and their physicians—facilitating the implementation of innovative care models that will improve care quality and lower costs," American Medical Association Executive Vice President and CEO James L. Madara, MD, said in a statement. “Patients will be able to get the care they need and deserve.”
Stay tuned as we follow up on this vote with reaction from those in the imaging community and throughout healthcare.