Schwartz emphasized that her bill is farther along in the process, a point echoed by Anders Gilberg, senior vice president for government affairs at the Medical Group Management Association. The group backs elements in the Pennsylvania Democrat's bill that provide a period of stability, which is attractive to providers. But it also has an element that Gilberg thinks could be a sticking point down the road.
“There are differential payments for primary-care physicians, so there is some incentive to show preference for primary care, which has the potential cause for polarization in terms of support,” Gilberg said.
Schwartz's legislation would provide a 2.5% annual increase between 2015 and 2018 for primary care, preventive, and care coordination services by clinicians for whom 60% of their Medicare charges are those services. Meanwhile, all other physicians services would see a .5% increase each year for four years.
Neither Schwartz's legislation nor the draft bill from the Energy and Commerce Committee include how to pay for repealing the SGR, which the Congressional Budget Office now estimates will cost about $139 billion over the next decade, down considerably from previous estimates. The Energy and Commerce aide said the panel will include a way to pay for the fix in its legislation.
The lower price tag on an SGR repeal makes it more attractive to act now, according to Dr. Jeffrey Rich, director at large of the Virginia Cardiac Surgery Quality Initiative and immediate past president of the Society of Thoracic Surgeons. “Now seems like a critical time with sequestration and economic pressures for everything the government pays for,” he said.
On Monday, House Energy and Commerce Chairman Fred Upton (R-Mich.) told Modern Healthcare that he still plans for his panel to consider legislation to repeal the SGR before Congress breaks for the August recess.
Follow Jessica Zigmond on Twitter: @MHjzigmond