New Proposal to Eliminate SGR Gaining Traction
APA has responded to the latest iteration of a proposal by Republicans in the House of Representatives to eliminate the Sustainable Growth Rate component of the Medicare payment formula in a letter Tuesday to Rep. Dave Camp (R-Mich.), chair of the House Ways and Means Committee, and Rep. Fred Upton (R-Mich.), chair of the Energy and Commerce Committee. The proposal, still evolving and not yet translated into draft legislation, has gained traction as a substantive policy proposal from key House committees after years of congressional inaction on replacing the SGR system. In addition, the Congressional Budget Office recently released estimates that put the overall costs of eliminating the SGR much lower than previously expected. (The SGR mandates that increases in Medicare volume be offset by decreases in physician pay, without taking into account practice costs and inflation. The new lower CBO estimates of the cost of eliminating SGR are the result of substantially lower increases in Medicare volume). The new proposal may be the best chance for eliminating the SGR formula, according to APA’s Division of Government Relations. But the proposal is also linked to significant overall reforms of Medicare and physician payment. In the letter to Upton and Camp, APA addresses the complexities of the proposal and raises a number of questions pertinent to psychiatrists. To read the APA letter go HERE.
Congress Clears Legislation to Avert Sequestration & Block Medicare Physician Payment Cut
At 11:00 p.m. on January 1, the House of Representatives voted 257 to 167 to approve a Senate-passed bill to temporarily stop across-the-board spending cuts required by sequestration. The bipartisan budget package -- negotiated by Vice President Joe Biden and Senate Minority Leader Mitch McConnell (R-KY) – had already passed the Senate by an 89-8 vote at 2:00 a.m. on January 1. Click HERE for more.
Large Medicare Fee Cut Still Looming
In the absence of congressional action, and despite efforts by APA and other medical organizations, an across-the-board cut of 26.5 percent in payment for physician services under Medicare will go into effect on January 1, according to a final rule issued in November by the Centers for Medicare and Medicaid Services (CMS). An additional 2 percent could be shaved from physician pay if “sequestration” goes into effect; that refers to severe austerity measures mandated by this summer’s budget agreement—tax hikes and sharp cuts in government spending—that would be imposed if Congress and the administration fail to reach a deficit-reduction agreement. At press time, the fate of the scheduled fee cut was still contingent on congressional action. The Medicare fee final rule is posted HERE. How did Medicare evolve to its present state of complicated rules and formulas? Watch this seven-minute VIDEO that traces the history of Medicare and highlights the program’s impact on the 50 million elderly and disabled Americans it serves today.
New Provider Notice
The Illinois Department of Healthcare and Family Services has posted a new Provider Notice to the All Medical Assistance Provider Notices page. You may view the All Medical Assistance Provider Notices page HERE.
Psychologists Argue for the Right to Prescribe Medicines
Psychologists have traditionally not been allowed to prescribe medications for their patients, but some argue that giving them this right would be better for patients, and is also vital to the future of the profession. Click HERE for full article.