SGR Repeal Won’t Save All Docs from Medicare Payment Cuts

WASHINGTON, D.C. — While providers and industry groups hailed Tuesday’s long-awaited repeal of the controversial sustainable growth rate (SGR) formula, some doctors who treat Medicare patients will still see the 21{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} reimbursement cuts that the Senate’s last-minute vote was intended to avoid, the Hill reports.

Had the Senate not voted 92-8 to repeal SGR just before 10 p.m. Tuesday, across-the-board payment cuts would have taken effect for Medicare doctors, as the latest in a string of temporary patches to the legislation was set to expire Wednesday. The House of Representatives passed its own version of the ‘doc-fix’ bill in a 402-12 vote in March, and President Obama is expected to sign the legislation, called the Medicare Access and CHIP Reauthorization Act. Physician groups had heavily lobbied Congress to repeal the unpopular law, which was originally intended to curtail Medicare spending but instead left physicians across the country habitually uncertain about the future of their reimbursements.

That uncertainty isn’t over for some physicians, however. The Centers for Medicare & Medicaid Services (CMS) wrote in a letter to providers Wednesday that, while it will immediately begin work to implement the SGR replacement, it will still have to process a small volume of claims at the reduced rate, according to the Hill. This is because it will take CMS a couple of days to update its systems to reflect the new law, spokesman Aaron Albright wrote in an e-mail to the newspaper, adding that he doesn’t know how many providers it will impact.

CMS told lawmakers that it will wait until April 15, rather than its usual deadline of March 31, to send out checks to physicians, according to the Hill, and its Wednesday letter to providers noted that the agency will reimburse those doctors who receive temporary payment cuts after it reprocesses their claims.

Still, groups such as the American Medical Assoc. have made it clear they welcome Congress’ repeal of SGR, saying it will allow the healthcare community to better focus on improving patient care and controlling costs, FierceHealthcare reported. Similarly, at a National Coalition on Health Care forum Wednesday, panelists laid out how the SGR replacement will further accelerate the industry’s shift from fee-for-service to value-based payment models.