Physician SGR Formula

News & Analysis as of

If It’s Broken, Fix It (At Least Temporarily): New “Doc Fix” Law Prevents Automatic Medicare Pay Cuts to Physicians

Were you worried that your physician pay rate would plummet come March 31 due to Medicare’s sustainable growth rate (“SGR”) formula? You can stop pulling out your hair, at least until next year. On April 1, 2014, President...more

Health Law Wire: Physician Medicare Revalidation Notice

On January 29, 2014, the National Government Services, Inc. announced that it would begin mailing out revalidation notices (“Notice”) to physicians enrolled in the Medicare program sometime in the next (12) months. Physicians...more

Number 17: Congress Patches the SGR Yet Again

For the 17th time since the Sustainable Growth Rate (SGR) became law as part of the Balanced Budget Act of 1997, last week the Congress passed a short-term “patch” to prevent scheduled cuts from going into effect for...more

ICD-10 Delayed Again

While I didn’t intend for the theme of my Health Care Law Today posts to be delays, there is no shortage of postponements to write about lately. The House and Senate passed H.R. 4302, Protecting Access to Medicare Act of...more

Congress Delays Medicare Cuts until 2015

On March 31, the Senate voted to pass yet another “doc fix” bill, which had been approved by the House the week before. This doc fix bill marks the 17th time that Congress has postponed the implementation of the Medicare...more

Health Care Update

In This Issue: Implementation of the Affordable Care Act; Other Federal Regulatory Initiatives; Other Congressional and State Initiatives; Upcoming Hearings and Markups; Excerpt from Implementation of the...more

House Passes SGR “Doc Fix” Legislation

On March 27, 2014, the House of Representatives passed H.R. 4302, which will postpone the scheduled 24% Medicare physician reimbursement cut by an additional one year. Several groups opposed the Bill as yet another temporary...more

MGMA Special Alert – SGR Repeal

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...more

Latest SGR Repeal News from MGMA

Today the House of Representatives passed by voice vote H.R. 4302, which would temporarily delay the 24% cut to Medicare physician payments resulting from the sustainable growth rate (SGR) formula for one year. MGMA has...more

Health Care Reform Implementation Update - March 2014

On Sunday, the Affordable Care Act (ACA) turned four. Unsurprisingly, Democrats celebrated the law’s birthday by touting its many successes and Republicans used it to highlight the problems the law has faced, as well as...more

Health Care Reform Implementation Update - March 13, 2014

This week President Obama released his Fiscal Year 2015 Budget Proposal, which provides useful information on his priorities for the year but, as is normally the case, is not likely to gain much traction; the administration...more

The Doc Fix: Do We Finally Have A Permanent Solution?

Will physicians finally be free from worrying that their Medicare payments will be severely slashed? During the first week in February, Republicans and Democrats in the U.S. House of Representatives and Senate agreed on a...more

Congress Announces Agreement on Physician Payment Overhaul Legislation

On February 6, 2014, lawmakers reached an agreement to overhaul the Medicare physician payment system. The current sustainable growth rate (SGR) formula requires an annual cut in physician payments, which Congress typically...more

Health Care Reform Update -- February 10, 2014

In This Issue: Implementation of the Affordable Care Act; Other Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health News; and Hearings and Mark-Ups Scheduled. Excerpt from...more

Capital Thinking: Health Care

SGR Policy Framework Deal - Last week, the Chairmen and Ranking Members of the three committees of jurisdiction over Medicare (Senate Finance Committee, House Ways and Means and Energy and Commerce Committees) announced...more

Joint SGR Repeal Bill Agreed Upon, Moving to Full Congress

New joint legislation to repeal Medicare’s failed SGR formula is advancing to both chambers of Congress following an agreement announced Thursday by the three committees that put forth repeal bills earlier this...more

Funding Offsets Proposed for Physician Payment Overhaul

Congressional lawmakers are currently reviewing 65 potential funding offsets for legislation that would overhaul the Medicare physician payment system. In its present form, Medicare’s sustainable growth rate (SGR) formula...more

Capital Thinking: Health Care

SGR Reform Negotiations - Staff negotiations on a package to overhaul the sustainable growth rate (SGR) formula are gaining steam as the Committees of jurisdiction tackle a significant hurdle left unaddressed to date:...more

Healthcare Update: But How Will They Pay For It?

The end of 2013 proved a remarkable, albeit brief, period of bipartisanship as the Committees of jurisdiction worked together to adopt legislative solutions to several pressing national health care concerns. While the last...more

Also in the News

President Obama Signs Pathway for SGR Reform Act of 2013 – On December 26, 2013, President Obama signed the Pathway for SGR Reform Act of 2013 (the “Act”), preventing the scheduled payment reduction for...more

SGR-Driven Payment Reduction Postponed Again

As part of the Balanced Budget Act of 1997 (BBA), Congress enacted a number of payment reforms designed to curb the growth of expenditures under Medicare Part B. One of the more notable of those provisions was the Sustainable...more

President Obama Signs the Pathway for SGR Reform Act of 2013

On December 26, 2013, President Obama signed into law the Pathway for SGR Reform Act of 2013. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking...more

Health Care Reform Implementation Update - December 19, 2013

The deadline to enroll in coverage for January 1 was officially extended by a week, but the new December 23 deadline is fast approaching, and premium payments are required to be paid by the last day of 2013 for January 2014...more

Congress Passes 3 Month SGR Reprieve: .5% Medicare Physician Increase

The AMA Wire reports action on the Medicare Physician Fee Schedule. The payment increase staves off a 24 percent cut required by the failed SGR formula and buys three months for Congress to complete its work on SGR repeal...more

Senate and House Committees Pass Legislation that Would Reform the Sustainable Growth Rate Formula

On December 12, 2013, the Senate Finance Committee and House Ways and Means Committee both approved legislation that would reform the Sustainable Growth Rate (SGR) formula currently used for Medicare physician payments. ...more

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