Wednesday, March 24, 2010

Gregg Amendment (#3651) on Sustainable Growth Rate

Senator Gregg has offered an amendment (#3651) regarding the Medicare sustainable growth rate (SGR) mechanism.
Summary
  • The amendment provides a 0% increase in Medicare physician reimbursements for the balance of 2010 and all of calendar years 2011, 2012, and 2013.  The amendment provides that the adjustments through December 2013 not be taken into account when calculating the SGR for years 2014 and beyond.
Considerations
  • The PAYGO law recently approved by Congress allows an exemption for the “doc fix” for up to five years (through the end of 2014).
  • Many may view claims the health law and reconciliation bill are “deficit neutral” stem from the fact that these pieces of legislation do NOT address the SGR mechanism, resulting in 21 percent reductions in physician payments in March 2010, and further reductions in future years.
  • To the extent that an unpaid for “doc fix” results in higher Medicare spending on physician payments, one-quarter of that spending will be reflected in higher Medicare Part B premiums.