U.S. House Unveils New SGR Framework - Comments Welcome

From the AMA, April 3, 2013:  Today, the chairmen and health subcommittee chairmen of the House Energy and Commerce Committee and the House Ways and Means Committee issued a second, more detailed draft of their framework for repealing and replacing the SGR.  Like the first draft circulated prior to the AMA’s National Advocacy Conference, the committees are inviting physician groups to provide feedback and respond to committee staff questions on the proposal.  The deadline for feedback is April 15Read Draft 

In broad terms, the new framework offers a little more clarity on the three phases proposed in the original draft.  Under Phase 1, the SGR would be repealed and replaced with stable, predictable (statutorily set) updates for some period of time.  During Phase 1, it is envisioned that physicians would work on developing quality measures that could be incorporated into Phase 2.  During Phase 2, a portion of fee-for-service payments would be based on quality measures through an update incentive program.  During Phase 3, provider rates under fee-for-service could also be enhanced through additional incentives on efficient use of health care resources.   

These phases are most relevant to physicians who remain in Medicare fee-for-service.  Those who choose to participate in an alternative payment model would be exempt from the new performance-based fee-for-service system.

While many important details are still missing we view this proposal, once again, as generally consistent with the principles supported by the Federation last fall.  Physician groups should also be encouraged by the evidence that these key Committees remain actively engaged in finding a permanent solution to our Medicare payment system problem.

We welcome any feedback you may have to the proposal and the questions posed by the committee, and will share our response to this latest draft with Federation groups as soon as it is completed.

Please contact NHMS Executive Vice President, Scott Colby at scott.colby@nhms.org with any questions or comments.