In its annual March report to Congress (PDF), the Medicare Payment Advisory Commission reiterated its position from last fall that federal lawmakers should repeal Medicare's sustainable growth-rate formula and replace it with 10 years of statutory fee-schedule updates.
MedPAC continues to urge SGR repeal
That course of action would include a freeze in current payment levels for primary care, and, for all other services, reductions of 5.9% for three years, followed by a freeze. The March report contained the letter from MedPAC to federal lawmakers last Oct. 14 that included a host of ways to pay for repealing the SGR, such as applying an excise tax to Medigap plans, rebasing payments to skilled-nursing facilities and applying a readmission policy to skilled-nursing facilities, home health agencies, long-term, acute-care hospitals and inpatient rehabilitation services.
Mark Miller, executive director at MedPAC, told reporters that he is “not aware of any legislation” currently on Capitol Hill that aligns with the commission's recommendations. “On the one hand, people are very frustrated with the Congress: ‘Why don't you act?'” Miller said, referring to the current formula Medicare uses to reimburse physicians who participate in the program. “But as long as the cost of the action is $300 billion, they've got to figure out how they're going to finance it.”
Totaling more than 400 pages, the report presents to Congress suggestions on Medicare payment policy that MedPAC's commissioners agreed to in January, such as a 1% payment increase in payment rates to the inpatient and outpatient prospective payments systems for 2013. Other recommendations for 2013 include a payment update of 0.5% for the ambulatory surgery center and hospice segments, and no payment increases for skilled-nursing facilities, long-term-care hospitals and inpatient rehabilitation facilities.
The report also said Congress should direct the HHS secretary to begin a two-year rebasing of home health rates in 2013, and also establish a per-episode co-payment for home health episodes that are not preceded by hospitalization or post-acute-care use. MedPAC made both of those recommendations for the first time a year ago.
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