Healthcare Business News
Senator Sheldon Whitehouse, Rhode Island

SGR fix may be coming soon, senator says

By Jonathan Block
Posted: April 10, 2013 - 2:00 pm ET

Legislation that provides a permanent fix to Medicare's controversial sustainable growth-rate formula used in calculating physician reimbursement could be introduced in the Senate this year, according to a member of the Senate Health, Education, Labor and Pensions Committee.

Responding to a reporter's question, Sen. Sheldon Whitehouse (D-R.I.) said that a number of senators have been discussing legislation that would repeal the SGR. “Something's got to change,” said Whitehouse, who appeared at a Capitol Hill event Wednesday on payment reform sponsored by the Brookings Institution's Engelberg Center for Health Care Reform.

Although there have been discussions in the Senate, Whitehouse said, more debate on the topic “needs to percolate up through the Finance Committee.”

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The House is well ahead of the Senate in its SGR repeal efforts.

In February, Reps. Allyson Schwartz (D-Penn.) and Dr. Joe Heck (R-Nev.) introduced the Medicare Physician Payment Innovation Act, which includes repealing the SGR. Earlier this month, Rep. Fred Upton (R-Mich.), chairman of the Energy and Commerce Committee, and Rep. Dave Camp (D-Mich.), chairman of the Ways and Means Committee, issued a second draft of their repeal and replace proposal and sought comments from the provider community due by April 15.

Schwartz, who also spoke at the Brookings event, expressed optimism that a repeal of the SGR will get done this year. “The way we pay physicians in this country has got to change,” she said, adding that more progress needs to be made toward providing incentives for physicians to increase the quality of care and lower costs.

A repeal of the SGR may have a better chance this year than in previous years. The Congressional Budget Office lowered its estimate of the cost of a permanent SGR fix to $138 billion over 10 years. In August 2012, the office put the figure at $245 billion.

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