Pete Sessions, a Texas Republican, has introduced legislation in the U.S. House to replace Medicares current formula for paying physicians with more service-specific payment formulas. Physicians currently get paid under the programs sustainable growth-rate formula, or SGR, which is tied to the health of the economy and which has called for payment reductions since 2002. The CMS estimates that physician payments will drop by 10% next year unless the formula is replaced.
Sessions bill proposes to repeal the SGR and replace it with separate payment formulas for seven physician services, including evaluation and management, radiology and diagnostic tests, major procedures, minor procedures, anesthesia services, diagnostic laboratory tests and Part B drugs.
Unlike the SGR, which sets a single target for allowable growth on spending for all physician services, the new system would provide a statutory specified allowance in expenditure growth and bring more stability to the physician payment structure, Sessions said in a written statement.
A legislative package in the House to reauthorize the State Childrens Health Insurance Program contains a similar proposal to replace the SGR with six separate expenditure targets and replace the anticipated 10% cut with at least a 0.5% increase in 2008 and 2009. -- by Jennifer Lubell