Amended SGR Bill Passes House, But Senate Approval Doubtful

After months of wrangling, a call for a vote by House Majority Leader Eric Cantor on an amended version of the Sustainable Growth Rate (SGR) Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015), resulted in approval of the bill by a 237—182 margin. But the amended bill, authored by Dave Camp (R-Mich.), chairman of the House Ways and Means Committee, stipulates that no American will incur a penalty tax for failure to obtain government-approved health insurance until 2019.

That language will likely kill the bill in the Senate and derail physician groups’ attempts to have a permanent fix implemented before the SGR pay cut goes into effect after March 31. That means that physicians who treat Medicare patients will see a 24% payment cut.

In its original form, H.R. 4015 would have permanently repealed the SGR formula and given physicians a 0.5% pay increase for five years while alternative payment models based on incentives and value-based care could be phased in.

estimate

The Congressional Budget Office and the nonpartisan Joint Committee on Taxation that the cost to repeal the SGR is about $138.4 billion over 10 years, while Camp's amendment would save the government about $169.5 billion over a decade.

Physician groups weighed in with notable frustration. Ardis Dee Hoven, MD, president of the American Medical Association, said in a statement, “Continuing the cycle of kicking the can down the road through temporary patches in the months ahead simply wastes more taxpayer money to preserve a bad policy of Congress’ own making.”

“We're dismayed that Congress sabotaged their own work by linking legislation to unrelated, ideological issues—particularly in light of the nearly universal opposition to such action from patients, insurers and the medical community,” said Reid Blackwelder, MD, president of the American Academy of Family Physicians, in a statement reacting to the vote.