Reforming the Medicare Sustainable Growth Rate

H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act, builds on the foundation established by the Energy and Commerce Committee last July. H.R. 4015 reflects a bipartisan agreement reached by the House Energy and Commerce Committee, House Committee on Ways and Means, and the Senate Finance Committee in the ongoing effort to repeal and replace the SGR formula. H.R. 4015 was introduced on February 6, 2014 by Rep. Michael C. Burgess, M.D. (R-TX), Vice Chairman of the Energy and Commerce Health and Oversight and Investigations Subcommittees.  
 
READ a summary of the agreement here.

READ H.R. 4015 - the SGR Repeal and Medicare Provider Payment Modernization Act here.

WATCH Bipartisan Voices of SGR Reform here.

READ letters of support for SGR reform here.

Join the conversation on Twitter using the hashtag #FixSGR

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. 

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.