Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Doc Fix Is Coming, But When?

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A flurry of recent activity has renewed hope that a permanent fix to the flawed Sustainable Growth Rate (SGR) methodology will be enacted. The question is, “When?”

According to The Hill, House Speaker John Boehner and his team are putting together a proposal to permanently correct the SGR, which mandates how Medicare payments are set. That plan apparently includes negotiations with Minority Leader Nancy Pelosi.

Paul Demko of Modern Health reports that the Senate has been mostly kept out these talks, however, and the price tag to fund a permanent fix, estimated by the Congressional Budget Office at $175 billion over the next 10 years, remains in contention among lawmakers. Also, party-line disagreements over continued funding of the Children’s Health Insurance Program, which is set to expire at the end of September, as well as proposals to change the basic structure of current Medicare benefits have been thrown into the SGR debate. Whether these issues can be resolved and the Senate brought up to speed before the March 31 deadline remains unknown.

If no action is taken, physicians face a 21.2% decrease in Medicare payments on April 1, although no one expects Congress to allow that to happen. So far, a series of 17 consecutive short-term fixes have prevented any drastic cuts, and many experts anticipate another short-term fix to allow more time for negotiations on the permanent plan.

For more details about where the SGR debate stands, check out Becker’s Hospital CFO article, “Will there be a permanent ‘doc fix’ this year? 15 things to know.”

— All rights reserved. For use or reprint in your blog, website, or publication, please contact us at cipromsmarketing@ciproms.com. Photo by David Goehring via Flickr used with permission under the Creative Commons License.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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