After nearly 14 years of lobbying and 17 temporary “patches,” on April 14, 2015 — by an overwhelming margin of 92-8 — the U.S. Senate passed H.R. 2, the “Medicare Access and CHIP Reauthorization Act,” which repeals Medicare’s sustainable growth rate (SGR) payment system. The bill, which also passed the House of Representatives by a vote of 392-37, now goes to President Obama for his signature; thus preventing the 21 percent Medicare physician pay cut. As House Energy and Commerce Committee chairman, Fred Upton (R-Mich.) aptly stated, “Stick a fork in it, it’s finally done.”
- Repeals the SGR, prevents the 21 percent Medicare pay cut and provides physicians a period of payment stability with positive updates;
- Consolidates the current Physician Quality Reporting System (PQRS), Electronic Health Record (EHR) and Value-Based Payment Modifier (VM) programs, and eliminates the penalties associated with these programs;
- Includes positive incentives for quality improvement payment programs that allow all physicians the opportunity to earn bonus payments;
- Enhances the ability of physicians — rather than the government — to develop quality measures and clinical practice improvement activities;
- Clarifies that quality improvement program requirements do not create new standards of care for purposes of medical malpractice lawsuits;
- Reverses the CMS decision to eliminate the 10- and 90-day global surgery payments; and
- Extends the Children’s Health Insurance Program (CHIP) for two years.
Over the course of the next several years, organized neurosurgery will focus on guiding this legislation through the implementation process. It will be no small undertaking to ensure that CMS gets this right and develops the new Medicare physician payment system as directed and intended by Congress. The AANS and CNS will also redouble our efforts to repeal the Independent Payment Advisory Board (IPAB) and promote legislation that allows physicians to privately contract with the Medicare patients — two additional efforts to ensure the viability of physician practices and access to care for all Medicare beneficiaries.
So to the SGR, we say, into the trash heap of history you go and good riddance!