ADA Applauds Passage of the Medicare Access and CHIP Reauthorization Act

The Senate overwhelmingly voted to pass H.R. 2 late last (Tuesday) night, paving the way for repeal of the Medicare Sustainable Growth Rate (SGR) formula. This legislation, which passed the House of Representatives on March 26, permanently repeals the Medicare Sustainable Growth Rate (SGR) formula. President Obama publicly stated that he will sign the bill into law.

The vote came after years of negotiations to get rid of the much-maligned formula, known as the sustainable growth rate (SGR), in which Medicare physician reimbursements were linked to increases in the gross domestic product; the formula invariably resulted in payment cuts for physicians. The cuts were staved off each time by a series of payment "patches" passed by Congress.

The Medicare Access and CHIP Reauthorization Act (H.R. 2):
  • Erases all future SGR cuts and ensures a 5-year period of annual updates of 0.5% to transition to the new payment system;
  • Provides additional financial incentives for providers who move into alternative payment models (APMs);
  • Harmonizes and streamlines existing Medicare quality reporting programs into the Merit-Based Payment Incentive System (MIPS);
  • Reverses CMS' decision to eliminate the use of 10 and 90–day global surgical codes in Medicare.
  • Nowhere in the legislation has there been any indication that ICD-10 will be delayed. We anticipate ICD-10 will be implemented as scheduled on October 1, 2015.
As we get more information about implementation and timelines for the legislation, we will share it with ADA members.