AN END TO THE DOC FIX? (Medicare/TRICARE) Working with the House Committee on Ways and Means, leaders from the House Energy and Commerce Committee have unveiled draft legislation that would repeal the current Sustainable Growth Rate (SGR) system and replace it with a fair and stable system of physician payments in the Medicare program. Enacted in 1997 as part of the “Balanced Budget Act,” the SGR is a continued concern for physicians who serve Medicare beneficiaries and for the beneficiaries themselves. Because payments to doctors who treat TRICARE beneficiaries are tied to Medicare, it also affects active duty, reserve, and retired military personnel and their families. For years, Congress has implemented a temporary “doc fix” to prevent substantial Medicare reimbursement rate cuts, which could result in fewer physicians willing to serve Medicare/TRICARE patients. The draft legislation would replace the current SGR with an enhanced fee-for-service system, while allowing providers to opt out and participate in alternative payment models. A contractor would evaluate the alternative models through demonstration programs, and report on those that work best. Although the draft legislation provides a clearer picture of the proposed new payment system, it **does not address** how to pay for the cost of repealing the current payment system. The Congressional Budget Office estimates the **cost of repeal** would be $139.1 billion over 10 years. What’s next: Health Subcommittee Chairman Joe Pitts, R-Penn., said he plans to hold a markup of the legislation next month.
Posted on: Wed, 03 Jul 2013 03:07:51 +0000
Trending Topics
Recently Viewed Topics
© 2015