Pallone Applauds Historic Passage of Permanent SGR Fix

“For more than a decade, Congress has had to temporarily fix the flawed Sustainable Growth Rate (SGR) nearly twenty times since it was enacted,” said Pallone.  “Well, today is the last time that we will have to talk about the broken SGR.  The House has finally come together to fix it once and for all and it is an historic achievement to say the least.” 

MACRA creates much needed certainty for doctors and seniors alike by repealing the SGR and replacing it with H.R. 1470, the bicameral, bipartisan agreement that moves the Medicare payment system toward improved value and returns stability to physician payments.  Under this bipartisan agreement, the 21% cut in reimbursements for Medicare physicians, scheduled for April 1, would be averted.  It would be replaced with a 0.5% update through 2019, and Medicare would transition to a new reimbursement system that would incentivize quality and efficiency in the delivery of health care services.

The legislation preserves and extends the Children’s Health Insurance Program (CHIP), fully funding the program through September 30, 2017.  This funding extension will ensure that over 8 million children and pregnant women in low-income households continue to have access to health care coverage.

“Let us be clear, this bill does not just simply repeal and replace the SGR,” added Pallone.  “It importantly secures and extends critical funding for programs that improve the health and welfare of millions of children, families, and seniors across the country.”

MACRA would also permanently extend the Qualifying Individual (QI) program, which helps low-income seniors pay their Medicare Part B premiums and the Transitional Medical Assistance (TMA) program, which helps families on Medicaid maintain their coverage for one year as they transition from welfare to work.

The bill also provides nearly $8 billion in funding for Community Health Centers, the National Health Service Corps, and Teaching Health Centers over the next two years.  This funding will help serve 28 million patients and strengthen access to primary and preventive health care in communities across the country.

“This agreement took courage from both sides, but what we have accomplished here in the House today is truly significant,” said Pallone.  “Compromise has resulted in a balanced and thoughtful product that means real solutions for everyday Americans.  I urge the Senate to take up this bill without delay and bring an end to this decade-long uncertainty once and for all.” 

The SGR formula is a cap on aggregate spending on physicians’ services where exceeding the cap resulted in punitive recoupments in subsequent years.  The formula, which was passed into law in the Balanced Budget Act of 1997 to control physician spending, has failed to work and resulted in nearly 20 short-term patches.  Since 2003, Congress has spent nearly $170 billion in short-term patches to avoid unsustainable cuts imposed by the flawed SGR.  The most recent patch is set to expire on March 31, 2015.