Reforming the Medicare Sustainable Growth Rate

H.R. 2, the Medicare Access and CHIP Reauthorization Act, builds upon the foundation established by the Energy and Commerce Committee in the 113th Congress and the legislative solutions outlined in H.R. 1470, the SGR Repeal and Medicare Provider Payment Modernization Act. This bill reflects the bipartisan, bicameral effort to permanently fix the Medicare payment formula and protect seniors’ access to their Medicare physicians. This legislative package will also strengthen Medicare's for today's seniors and future generations and extend the Children's Health Insurance Program. 

READ H.R. 2 here

READ a section-by-section of the bill here

READ a summary of the agreement here

Background

Enacted in 1997 as part of the Balanced Budget Act, the SGR has been a source of continued concern for physicians who serve Medicare beneficiaries and for the beneficiaries themselves. Long recognized as an imperfect solution that rewards quantity of services rather than the quality of care, Congress has repeatedly implemented a temporary “doc fix” to prevent substantial Medicare reimbursement rate cuts, which could result in fewer physicians being able to serve Medicare patients.

SGR Reform Milestones

February 7, 2013 - Energy and Commerce and Ways and Means Committee leaders outline a framework to reform the current Medicare system. Committees asked for feedback on the outline by February 25.

February 14, 2013 – Energy and Commerce Subcommittee on Health held a hearing on “SGR: Data, Measures and Models; Building a Future Medicaid Physician Payment System.”

April 3, 2013 – Leaders from the House Energy and Commerce and Ways and Means Committees outlined additional details of a proposal to repeal the SGR system. The leaders also sent a letter to the provider community requesting feedback. The leaders requested stakeholder feedback by April 15.

May 28, 2013 - the Energy and Commerce Committee unveiled a draft legislative framework, seeking further stakeholder input by June 10.

June 5, 2013 – Subcommittee on Health held a hearing on “Reforming SGR: Prioritizing Quality in Modernized Physician Payment System.”

June 28, 2013 - Transparent Medicare Physician Payment Process Gained Momentum - Committee Released Advanced Legislative Framework.

July 18, 2013 - Committee Released Updated Draft Proposal for Medicare Physician Payment Reform.

July 23, 2013 - Health Subcommittee Advances Bipartisan SGR Replacement.

July 31, 2013 - Full Committee approves H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 by a bipartisan 51-0 vote.

February 6, 2014 - The SGR Repeal and Medicare Provider Payment Modernization Act, H.R. 4015, is introduced by Rep. Michael C. Burgess, M.D. (R-TX). H.R. 4015 reflects a bipartisan, bicameral agreement by the Energy and Commerce Committee, House Committee on Ways and Means, and Senate Finance Committee. Read more about this agreement here.

March 14, 2014 – The House approved H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act introduced by Rep. Michael C. Burgess, M.D. (R-TX). 

March 27, 2014 – The House approved H.R. 4302, the Protecting Access to Medicare Act, introduced by Health Subcommittee Chairman Joe Pitts (R-PA). This legislation, which is fully paid for, would protect seniors’ access to their trusted Medicare physicians. 

Januray 21, 2015 - #SubHealth Kicks Off Discussion of Bipartisan Solutions to Strengthen Medicare and Permanently Resolve SGR

March 13, 2015 - Bipartisan Joint Committee Statement on the Sustainable Growth Rate

March 17, 2015 - WHAT THEY’RE SAYING: Members and Experts Voice Support for Permanent Resolution to the SGR

March 19, 2015 - Senate, House Leaders Introduce SGR Replacement Bill

March 20, 2015 - House Leaders Release Working Summary Outlining Framework of Bipartisan SGR Agreement

March 23, 2015 - The Week Ahead: "Historic Opportunity" to Get SGR Done...For Good

March 24, 2015 - Bipartisan Committee Leaders Post SGR Package to be Considered THIS WEEK

March 25, 2015 - Support for Permanent #SGR Solution Continues to Grow

March 25, 2015 - Highlights of CBO Estimate of H.R. 2, The Medicare Access and CHIP Reauthorization Act of 2015

March 26, 2015 - Good Riddance! House Votes to Permanently Repeal the #SGR and Strengthen Medicare

April 10, 2015 - Key Findings From CMS Actuary's Report on H.R. 2

April 14, 2015 - Upton Statement on Senate Passage of H.R. 2

 

Additional Resources

April 11, 2013 - Responding to Senior's Needs and Improving Medicare Choices.

June 28, 2013 - What They're Saying on SGR Reform Effort: Members Weigh In On Advanced Legislative Framework to Permanently Fix Sustainable Growth Rate.

July 18, 2013 - Committee Discusses Permanent Replacements for SGR Formula to Avoid Looming Physician Reimbyrsement Cuts, Which Threaten Seniors' Access to Care.

July 22, 2013 - Letters of Support for the Bipartisan Medicare Physician Payment Reform Effort.

July 23, 2013 - Subcommittee on Health agrees to an advanced legislative framework by a Voice Vote.

July 23, 2013 - WHAT THEY’RE SAYING: Support Building for Bipartisan Medicare Physician Payment Reform Effort.