Congressional committees release Medicare payment reform proposal
Medicare physician payments would increase by 0.5 percent each year for five years under a new agreement on Medicare physician payment reform which would repeal the sustainable growth rate formula. The proposal still needs to be approved by both chambers and Congress will have to address the issue of how to pay for reform.
Read more about the payment reform proposal.
Medicare payment reform background
In December, Congress agreed to a three-month reprieve from the 24 percent Medicare physician payment cut that was scheduled to begin Jan. 1, 2014, and replaced the cut with a 0.5 percent increase.
The AADA has been actively engaged in the efforts to reform the Medicare physician payment system. During the past year, the AADA has worked closely with key lawmakers on several legislative proposals.
The outlook for achieving full-scale reform this year remains uncertain, but the AADA remains encouraged by the progress made to reform the Medicare physician payment system and will continue to be actively engaged in in these efforts. Cost of payment reform
In addition to support from the AADA and other specialty organizations, 18 members of the House Doctors Caucus have sent a letter to Congressional leadership in support of SGR repeal with the conditions that any provisions to offset the cost of reform do not hinder physicians’ ability to deliver high-quality care to patients.The Congressional Budget Office released a new estimate that HR 4015/S 2000 would cost $138 billion over an 11-year budget window.
AADA responds to congressional inquiries about Medicare physician payment reform
The AADA responded to several congressional inquiries about how to repeal and reform the flawed Medicare physician payment system:
AADA supports bill strengthening Medicare patients’ access to care
In April 2013, the AADA signed on to a coalition letter supporting legislation that would allow Medicare patients to access the physicians of their choice, even if the physicians are no longer accepting Medicare. Introduced by Rep. Tom Price, MD, (R-Ga.), HR 1310, the Medicare Patient Empowerment Act, would ensure that Medicare beneficiaries and physicians are able to freely contract for covered Medicare services without penalty, while providing important beneficiary protections.
Under the current law, Medicare beneficiaries who choose to see physicians who do not accept Medicare are required to pay the physicians' charges entirely out of pocket because Medicare does not pay any part of the charges.
In addition, physicians who choose to provide covered services to Medicare beneficiaries under private contracts must "opt out" of the Medicare program for two years, during which time Medicare does not pay the physicians for any covered services provided to Medicare beneficiaries.
If enacted, HR 1310 would significantly strengthen Medicare patients’ access to care. Read the AADA's letter of support.