News & Analysis as of

Physicians Centers for Medicare & Medicaid Services (CMS) Physician SGR Formula

Baker Donelson

Final Rule Implements Quality Payment Program under MACRA

Baker Donelson on

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

Robinson & Cole LLP

SGR Fix Bill Includes Important Change to Gainsharing CMP

Robinson & Cole LLP on

President Obama recently signed into law Public Law No. 114-10, the “Medicare Access and CHIP Reauthorization Act of 2015” (P.L. 114-10), which overhauls Medicare physician reimbursements by eliminating the use of the...more

Baker Donelson

MIPS: Moving Physician Payments Beyond the Sustainable Growth Rate?

Baker Donelson on

Medicare continues to transition its primary physician payment methodology from a traditional fee-for-service model into a quality and value-based model. Recently, the Medicare Access and CHIP Reauthorization Act of 2015...more

King & Spalding

President Obama Signs SGR Repeal Legislation; New Physician Payment Methodology Begins in 2019

King & Spalding on

On April 16, 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA repeals the Medicare Sustainable Growth Rate (SGR) that was set to cut Medicare Physician Fee...more

Mintz - Health Care Viewpoints

Beyond SGR – MACRA Provides Additional Payment Provisions and Offsets

This is the second post in our continuing series on the Medicare Access and CHIP Reauthorization Act (MACRA). Pub.L. No: 114-10. In addition to repealing the Sustainable Growth Rate (SGR), which was covered in our April 20th...more

Sheppard Mullin Richter & Hampton LLP

Congress Repeals Sustainable Growth Rate Formula and Advances Medicare Payment for Quality

On April 14, 2015, Congress ended over a decade of repeated “doc fixes” which temporarily suspended scheduled Medicare provider reimbursement cuts, by passing the Medicare Access and CHIP Reauthorization Act (the “Act”). If...more

Proskauer Rose LLP

New Medicare Law Advances Gainsharing

Proskauer Rose LLP on

On April 16, 2015, President Obama signed into law H.R.2, the Medicare Access and CHIP Reauthorization Act of 2015 (the "Act"), which provides for sweeping changes to how Medicare pays doctors. Specifically, the Act seeks to...more

Mintz - Health Care Viewpoints

With SGR Repealed, Replacement Policy Creates New Priorities

On April 16, 2015, President Obama signed into law, the “Medicare Access and CHIP Reauthorization Act of 2015” (MACRA), ending annual temporary patches and massive lobbying efforts since the late 1990s to prevent significant...more

King & Spalding

Permanent Doc Fix Bill Approved by House; Senate to Vote in Coming Weeks

King & Spalding on

Last week, the U.S. House of Representatives overwhelmingly voted 392-37 to approve the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2), a bill that would, among other things, permanently replace the sustainable...more

King & Spalding

CMS Releases CY 2015 Physician Fee Schedule Final Rule

King & Spalding on

On October 31, 2014, CMS released the CY 2015 Physician Fee Schedule (PFS) final rule. CMS calculated the conversion factor using the Sustainable Growth Rate (SGR). Due to the Protecting Access to Medicare Act of 2014, there...more

Tucker Arensberg, P.C.

CMS Releases Proposed 2015 Physician Fee Schedule and Projects 20.9% SGR Reduction

Tucker Arensberg, P.C. on

CMS has issued the Proposed 2015 Physician Fee Schedule and Fact Sheets for specific issues (ASC, ESRD, Home Health, Physician Quality Programs)....more

King & Spalding

Also in the News

King & Spalding on

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

Baker Donelson

SGR-Driven Payment Reduction Postponed Again

Baker Donelson on

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

Baker Donelson

CMS Releases Final Rule for 2014 Medicare Physician Fee Schedule

Baker Donelson on

CMS has released its much-anticipated final rule with comment for the Calendar Year (CY) 2014 Medicare Physician Fee Schedule (PFS). The final rule prescribes physician payment rates that will go into effect on January 1,...more

BakerHostetler

2014 Physician Fee Schedule: Cuts and Quality and Data! Oh My!

BakerHostetler on

The Centers for Medicare and Medicaid Services (CMS) recently released the calendar year 2014 Physician Fee Schedule Proposed Rule (Proposed Rule)....more

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