Discussions of ways to permanently or at least temporarily fix the sustainable growth rate (SGR) for 2013 – and prevent drastic cuts to physician payments – have started already.
“We’re seeing activity earlier on in the year than we have in the past,” says Miranda Franco, government affairs representative for the Medical Group Management Association (MGMA) in Washington, D.C. Whether Congress can agree to permanent fixes in the challenging budget environment remains to be seen, she adds.
In its review of CMS’ preliminary estimate of the 2013 update, the Medicare Payment Advisory Commission (MedPAC) reaffirmed its recommendation to repeal the SGR formula and replace it “with specified updates that would no longer be based on an expenditure-control formula,” the commission’s June report states.
MedPAC estimated that without fixes to the SGR formula, practices could expect a 27.5% decrease to the physician fee schedule’s conversion factor, according to the report. That’s slightly less than the 30.9% calculation in the 2012 Medicare Trustees Report.
In February, Congress extended the current temporary “doc fix” through Dec. 31 (PBN Blog 2/27/12).
MedPAC, among others, has urged Congress to find permanent solutions to the SGR problem.
“The temporary increases or ‘fixes’ to override the SGR formula are undermining the credibility of Medicare by engendering uncertainty and frustration among providers, which may be causing anxiety among beneficiaries,” MedPAC wrote in its report.
The report follows two informal roundtable meetings held May 10 and June 14 by the Senate Finance Committee to discuss permanent fixes to the SGR formula (PBN Blog 5/10/12).