SGR Repeal Legislation

SGR Repeal Legislation

HR 2 passed the US House of Representatives on March 26, 2015 and will available for Senate action in mid April. The following information about HR 2 is supplied by the American College of Surgeons. You can also access FAQ concerning HR 2 https://www.facs.org/advocacy/federal/medicare/faq

Key Provisions of the Medicare Access and CHIP Reauthorization Act HR 2

  • Full and permanent repeal of the broken sustainable growth rate (SGR) formula used to calculate Medicare physician payments
  • Annual positive updates of 0.5 percent from July 2015 to 2019
  • Maintenance of fee-for-service as a payment option
  • Elimination of current-law penalties from the existing quality programs, such as the Physician Quality Reporting System (PQRS), Electronic Health Record (EHR) Meaningful-Use Program and the Value-Based Modifier (VBM) Program in 2019, and combining these programs into a single Merit-Based Incentive Payment System (MIPS). The merit-based program would be based on physicians achieving a threshold, or benchmark. Such a system makes it possible for all providers who reach these quality benchmarks to achieve positive incentives or payment updates
  • Incentives to move into advanced alternative-payment models (APMs), including 5 percent bonus payments from 2019 to 2024, and exemption from some other reporting requirements
  • Inclusion of appropriate pathways for surgeons to develop, test, and participate in APMs, such as the Clinical Affinity Groups (CAGs) in ACS’s Value-Based Update (VBU) proposal
  • Prohibits CMS from implementing its plan to transition 10- and 90-day global payments to 0-day global payments
  • Clarification that no standard or guideline created under federal health programs shall be construed as setting the standard of care for purposes of malpractice claims.