Senate passed SGR patch and ICD-10 One Year Delay

The Senate passed legislation (H.R. 4302), which delays for one year a 24% cut to Medicare physician payments resulting from the sustainable growth rate (SGR) formula. The legislation also pushed the ICD-10 compliance deadline to October 1, 2015. The SGR legislation provisions were:

  • Extends  the 1.0 work Geographic Practice Cost Index (GPCI) floor and therapy cap exceptions process for one year
  • Delays the transition to ICD-10 for at least one year
  • Creates new Medicare policies for clinical diagnostic laboratory tests
  • Puts in place “appropriate use” criteria for certain imaging services
  • Creates a new process for identifying “misvalued codes” in the Medicare Physician Fee Schedule

For more information, access the legislation available here.

SGR One Month Fix Passed; A “Kick the Can” Approach

This afternoon, the House of Representatives, by voice vote, passed the bill, (HR 5712) that provides for a one month delay in the 23 percent cut in payment rates that otherwise would have taken effect on December 1st.  Recall that the bill passed the Senate before the Thanksgiving recess.

While some Congressional leaders want to permanently fix the SGR, the costs to do so remain a big obstacle.  As an example, the costs to fix this for one year are about $19 billion.  The next deadline before the cuts take place is January 1st.  Whether the Congress deals with this issue before they adjourn, or the next new Congress deals with it (retroactively) remains to be seen.