The Senate passed legislation to permanently repeal the sustainable growth rate (SGR) formula just hours before a 21.1 percent cut in the Medicare physician fees was scheduled to occur. The move was cheered by leading cardiology societies, which for many years had advocated for change.
President Obama has said he would sign the bill into law when it crosses his desk.
The Senate voted 92-8 in support of H.R. 2, or the Medicare Access and CHIP Reauthorization Act of 2015, a House bill that put an end to the SGR and replaced the payment formula with a 0.5 percent annual increase beginning in July that will continue through 2019. The evening vote followed a day of haggling over amendments and funding concerns.
The SGR has been an annual thorn in the side for more than a decade for physicians and the societies that serve them. The flawed formula was designed in the late 1990s as a way to keep Medicare costs in line with the national economy. Since 2003, Congress has passed temporary measures rather than resolve the problem.
Last year a bipartisan proposal came close to passage, only to be shelved with a patch placed through March 31, 2015, to fend off the funding cut. The House passed its bill 393-37 before the witching hour. The Senate chose to go into recess, with the assurance that the Centers for Medicare & Medicaid Services could hold off processing claims until April 15.
The American College of Cardiology (ACC) and the Society for Cardiovascular Angiography and Interventions (SCAI) were among numerous medical associations to work with lawmakers on the bill’s passage. The act shifts the payment model from a volume-based reimbursement system to one that emphasizes quality and value. It also extends funding for the Children’s Health Insurance Program for two more years.
“Today is an exceptional day for Medicare patients and for the medical professionals who care for them, thanks to the long-awaited permanent repeal of the flawed sustainable growth rate formula,” Kim Allan Williams Sr., MD, ACC’s president, said in a statement. “The Senate has accomplished a major feat by passing legislation that ends a cycle of delays and patches in the law, which has created uncertainty for Medicare patients and clinicians for more than a decade.”
Charles Chambers, MD, president of SCAI, called the passage “a historic moment” in an email sent to members and he encouraged interventional cardiologists to remain involved in future policy initiatives. “Just as today closes the book on the SGR, it also opens a new chapter for the U.S. healthcare system, one in which we must be fully engaged,” he wrote. “This will mean working closely with Medicare officials and Congress to ensure that the new payment models reward the delivery of high-quality care that will help our patients live longer and feel better.”
The act may not provide relief for physicians in the long term, according to Medicare’s chief actuary. He warned that under the current plan, most physicians would experience a reduction in payments in 2025.