The House Ways and Means and Senate Finance Committees have released the outline of bipartisan, bicameral Medicare physician fee schedule/sustainable growth rate (SGR) formula reform legislation. The plan would impose a 10-year freeze on base physician fee schedule payments, but it would provide doctors with the opportunity to earn performance-based incentive payments. The plan also addresses, among other things: physician participation in alternative payment models, complex chronic care management, denial of payment for advanced imaging and electrocardiogram services failing to meet appropriateness criteria, and reforms aimed at identifying and revaluing misvalued services. Notably, the outline does not address offsets for the costs associated with the SGR reform, which will be a major point of contention moving forward (the Congressional Budget Office estimated earlier this year that freezing of physician payments over the next 10 years would cost $139 billion). Comments on the draft will be accepted until Tuesday, November 12, 2013.
This article is presented for informational purposes only and is not intended to constitute legal advice.