Bipartisan leaders on the House Energy and Commerce Committee released the latest iteration of a draft bill (PDF) to repeal Medicare's sustainable growth-rate formula. The plan calls for a five-year period of stable payment increases as physicians transition into new payment models. Still to come are ways to pay for the repeal, which the nonpartisan Congressional Budget Office estimates will cost about $139 billion over 10 years.
Totaling 70 pages, the bill is still a work in progress, as the panel's health subcommittee will consider changes to the legislation next week. Committee members—along with members of the House Ways and Means Committee—have worked throughout the year to craft a bill that has incorporated comments from more than 80 stakeholders. Like previous versions, the bill gives providers the option of leaving traditional Medicare fee-for-service to try new payment models that emphasize better quality and lower costs. What sets it apart from earlier drafts is a proposal to increase payment rates for all physician services by 0.5% every year from 2014 through 2018. That payment increase would continue beyond 2018, and physicians would also have the opportunity to receive an additional 1% increase depending on how they fare in a quality incentive update program, according to staff on the committee's majority side.
Not surprisingly, the bill does not mention how to pay for repealing the SGR. Staff members for the GOP side said members have been clear from the outset that they want to first develop a new, sensible physician payment system and then identify the necessary offsets to pay for it.