Bipartisan, Bicameral Agreement Marks Next Step in Process to Repeal Flawed SGR Formula and Replace it With a System Aimed At Protecting Seniors
WASHINGTON, DC – House Energy and Commerce Committee leaders today applauded the bipartisan agreement reached by the Energy and Commerce Committee, House Committee on Ways and Means, and Senate Finance Committee in the ongoing effort to repeal and replace the Sustainable Growth Rate formula. Rep. Michael C. Burgess, M.D. (R-TX) formally introduced the House legislation, the SGR Repeal and Medicare Provider Payment Modernization Act, H.R. 4015, reflecting the agreement this afternoon.
“This agreement marks another important milestone in the effort to repeal and replace the flawed SGR formula and provide peace of mind to our seniors that they will continue to have access to the highest quality of care,” said full committee Chairman Fred Upton (R-MI). “Much work remains to create a system that can finally provide certainty to seniors and their doctors. I look forward to building upon this progress and continuing the momentum until this is across the finish line.”
“Ultimately this is about ensuring our nation’s seniors have access to the highest quality of care. That means providing certainty to the physicians who treat them and ensuring they have the resources necessary to deliver the best care possible,” said Health Subcommittee Chairman Joe Pitts (R-PA). “This agreement builds upon an important foundation established last summer in the Energy and Commerce Committee. I am proud to support the progress made today knowing that it is the best possible agreement for both seniors and their doctors.”
“There is no more destructive or pernicious federal policy for the delivery of health care to America’s seniors than the Sustainable Growth Rate Formula,” said Vice Chairman of the Health and Oversight and Investigations Subcommittees Michael C. Burgess, M.D. (R-TX). “Today, for the first time, Congress has come together in a bipartisan fashion and among all committees of jurisdiction to show the seriousness of removing the SGR. This bill puts medicine back in charge and allows providers to work collaboratively with CMS to determine the appropriate methodology to accurately measure quality. In addition, by maintaining a fee for service option, more providers are likely to remain in the system. The progress we have made this year toward repealing and replacing the SGR is unparalleled, but it is not the end of our efforts. We will continue to fight for a stable update beyond the first five years.”
This agreement repeals the flawed SGR formula and replaces it with a system focused on quality, value, and accountability. The agreement incentivizes the highest quality of care for seniors with the use of quality measures determined by physicians and stakeholders themselves. The policy ensures that providers compete on a level playing field to deliver the best care possible to Medicare beneficiaries. This agreement provides for five years of 0.5 percent positive updates in physician payments as well as a provision to determine what further updates may be necessary. This is intended to prevent harmful cuts to Medicare physicians that would ultimately threaten seniors’ access to care. Ultimately, the agreement seeks to strengthen the integrity of the Medicare program and protect seniors’ access to quality care.
The House Energy and Commerce Committee in July 2013 unanimously approved legislation to repeal and replace the Medicare Sustainable Growth Rate. Read more about the committee’s leadership on this issue online here.
Read a one-page summary of the agreement online here.