Senate Fails to Address Payment Reform; 21% Cut Begins April 1

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

FutureDO2016

Full Member
10+ Year Member
Joined
Mar 22, 2013
Messages
531
Reaction score
86
Senate Fails to Address Payment Reform; 21% Cut Begins April 1
On Thursday, the House of Representatives approved comprehensive physician payment reform that will permanently avert cuts under the sustainable growth rate formula (SGR). However, the Senate postponed their vote on the legislation until after spring recess.
What this means for you
The 21% payment cut will take effect on April 1, 2015.
Like us, the Centers for Medicare and Medicaid Services (CMS) has urged Congress to ensure these cuts do not take effect. The agency has the authority to hold claims for up to 10 business days and stated on March 24 that Medicare Physician Fee Schedule claims for services rendered on or before March 31 are unaffected by the payment cut. CMS will notify physician by April 11 about next steps.

Does this mean all doctor's salaries are going down?

Members don't see this ad.
 
Senate Fails to Address Payment Reform; 21% Cut Begins April 1
On Thursday, the House of Representatives approved comprehensive physician payment reform that will permanently avert cuts under the sustainable growth rate formula (SGR). However, the Senate postponed their vote on the legislation until after spring recess.
What this means for you
The 21% payment cut will take effect on April 1, 2015.
Like us, the Centers for Medicare and Medicaid Services (CMS) has urged Congress to ensure these cuts do not take effect. The agency has the authority to hold claims for up to 10 business days and stated on March 24 that Medicare Physician Fee Schedule claims for services rendered on or before March 31 are unaffected by the payment cut. CMS will notify physician by April 11 about next steps.

Does this mean all doctor's salaries are going down?

Yes and no. Basically the senate called a recess and won't vote on the issue until 2 weeks from now. So on April 1st medicare will decrease by 21%, however it takes longer than 2 weeks to process those payments and by the time the payments get processed the senate will supposedly have passed the bill by then. Apparently this bill has a large amount of support in the senate so it is expected to pass. The only people who are looking to vote against it are fiscal conservatives because it is expected that this bill will cost another 214 billion over the next decade.
 
Oh thanks for clarifying. I kept getting emails saying the bill was passed by the House of Reps and expected to pass in the Senate, but then they went to recess and there was going to be a cut.
 
Members don't see this ad :)
Yes and no. Basically the senate called a recess and won't vote on the issue until 2 weeks from now. So on April 1st medicare will decrease by 21%, however it takes longer than 2 weeks to process those payments and by the time the payments get processed the senate will supposedly have passed the bill by then. Apparently this bill has a large amount of support in the senate so it is expected to pass. The only people who are looking to vote against it are fiscal conservatives because it is expected that this bill will cost another 214 billion over the next decade.

they should have waited until 2017. once a gop dude is president there will no longer be any fiscal conservatives in congress. :)
 
Update:

On Tuesday, the U.S. Senate voted to repeal the Medicare sustainable growth rate (SGR) formula, an action the AOA and the osteopathic profession have been advocating for throughout more than a decade.

The repeal is part of the Medicare Access and CHIP Reauthorization Act of 2015, which the U.S. House of Representatives also approved.

The Centers for Medicare and Medicaid Services began using the SGR to calculate payments to physicians for providing services to Medicare patients in 1998. Since then, Congress has repeatedly passed last-minute legislation to prevent the SGR formula’s steep cuts to physician payments. In 2014, a Congressional patch saved physicians from a 24.4% payment cut—but only temporarily. On April 1, the latest patch expired, cutting physician Medicare payment by 21%.

The new legislation fully repeals the SGR formula. Physicians no longer have to worry about such drastic looming cuts. In place of the SGR formula, they will see a 0.5% payment increase in the second half of 2015 and 0.5% raises every year following through 2019. In addition, the bill will create a new Medicare payment system based on quality of care rather than volume. The new system will encourage physicians to use alternative payment models such as the patient-centered medical home.

http://thedo.osteopathic.org/2015/04/dollars-and-at-long-last-sense-congress-repeals-sgr/
 
The good news is that this flowed system is gone.

The bad news is that the 0.5% increase will not be sufficient to overcome the ~3% annual inflation rate, so by the end of the five years, despite of an absolute reimbursement increase of ~3%, there will be a ~13% decline in effective income (due to the decline of the purchase power of the dollar).

With that said, I think it's good overall. Let's celebrate the fact that the SGR formula is gone, and save the other fight for another day :)
 
The good news is that this flowed system is gone.

The bad news is that the 0.5% increase will not be sufficient to overcome the ~3% annual inflation rate, so by the end of the five years, despite of an absolute reimbursement increase of ~3%, there will be a ~13% decline in effective income (due to the decline of the purchase power of the dollar).

With that said, I think it's good overall. Let's celebrate the fact that the SGR formula is gone, and save the other fight for another day :)

I agree with you but as always, there's not good representation of physician rights in D.C. or the people fighting for us are not doing their job.
 
  • Like
Reactions: 1 user
Top