If enacted, a bill to restructure the sustainable growth-rate formula that determines Medicare payment rates for physician services would increase government spending by about $210 billion for the period between 2010 and 2019, according to a cost estimate released by the Congressional Budget Office.
The bill, known as the Medicare Physician Payment Reform Act, would prevent a scheduled 21.2% rate decrease set to take effect next year.
The $210 billion total includes an additional $195 billion for Medicare payments to physicians and $64 billion in new spending for Medicare Advantage and the Defense Department's Tricare program. These increased costs would be offset somewhat by an increase of $49 billion collected from Medicare Part B premiums. In July, the CBO released an estimate that put the cost of fixing the SGR under provisions in earlier legislation, the America's Affordable Health Choices Act, at $245 billion for the same period.
The bill has been supported by the American Medical Association, and AMA President J. James Rohack said the measure would institute a realistic way to pay physicians that more accurately reflects the costs physicians accrue. He called the SGR “neither sustainable nor growing.”