MGMA Special Alert – SGR Repeal

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Senate approves House-passed SGR patch

Today, by a vote of 64-35, the Senate agreed to legislation passed by the House of Representatives, H.R. 4302, which delays for one year a 24% cut to Medicare physician payments resulting from the sustainable growth rate (SGR) formula. The legislation is expected to be signed into law by the President. In addition to the SGR provisions, the legislation:

  • Extends the 1.0 work Geographic Practice Cost Index (GPCI) floor and therapy cap exceptions process for one year
  • Delays the transition to ICD-10 for at least one year
  • Creates new Medicare policies for clinical diagnostic laboratory tests
  • Puts in place “appropriate use” criteria for certain imaging services
  • Creates a new process for identifying “misvalued codes” in the Medicare Physician Fee Schedule

MGMA did not support this bill and is disappointed Congress was not able to take advantage of the unprecedented bipartisan, bicameral efforts made this year to advance legislation to permanently repeal the SGR. Continuing the cycle of kicking the can down the road through the use of temporary, short-term solutions to this problem creates instability .


DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Tucker Arensberg, P.C. | Attorney Advertising

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