Appropriateness criteria, ICD-10 delay part of temporary SGR patch

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 - Congress, House, Senate

Despite hopes that early 2014 would finally see permanent repeal and replacement of the current flawed sustainable growth rate (SGR) formula, a looming deadline appears to have forced another temporary patch, as a 12-month SGR fix will go to a vote in the U.S. House of Representatives today.

The bill would preserve physician compensation levels and avoid a steep 24 percent physician pay cut set to kick in on March 31 if no action were to be taken.

In a move that gained the support of the American College of Radiology, the bill would also require physicians to consult appropriateness criteria when ordering advanced medical imaging for Medicare beneficiaries. The Secretary of the U.S. Department of Health and Human Services would determine how these criteria could be accessed.

“The imaging appropriateness criteria provisions in this SGR bill will help ensure that patients get the right exam for the right condition and avoid care they may not need,” said Paul H. Ellenbogen, MD, FACR, chair of the ACR board of chancellors, in a statement. “This would raise quality of care and preserve resources without intruding in the doctor-patient relationship or affecting access to care.”

Another major addition to the SGR bill is a one-year delay for the implementation of ICD-10.

The bipartisan bill was the product of House and Senate negotiations and, should it pass the House today, would likely be taken up by the Senate on Friday.