Articles and Blogs

Despite Lack of Senate Action, Medicare Physicians Won’t Face Pay Cut Late last week, the Senate recessed for its Easter break without taking action on legislation to permanently repeal and replace the Sustainable Growth Rate (“SGR”).  The House had passed the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2), known as the SGR replacement,... READ MORE

House Approves SGR Repeal On Thursday, March 26, the House overwhelmingly approved the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) to repeal the Medicare physician payment formula.  The bill passed with a vote of 392-37, with the support of 212 Republicans and 180 Democrats.  The legislation now shifts to the... READ MORE

Lawmakers Moving Closer to Permanent SGR Repeal and Replacement On Thursday, March 19, House leaders, led by Rep. Michael Burgess, M.D. (R-TX), introduced part of a legislative package to permanently repeal and replace the Medicare physician payment formula known as the Sustainable Growth Rate (“SGR”), which is set to expire on March 31. However, the... READ MORE

Rumors Swirl as Deadline for SGR Deal Nears With the Sustainable Growth Rate (“SGR”) “patch” set to expire on March 31, 2015, House Speaker John Boehner (R-OH) and Minority Leader Nancy Pelosi (D-CA) have been discussing a possible deal on a permanent repeal and replacement of the physician payment formula.  Earlier in the week,... READ MORE

House Republicans Release ACA Alternative On Monday, March 2, the chairmen of the three health-related committees in the House of Representatives, Reps. Paul Ryan (R-WI), Fred Upton (R-MI) and John Kline (R-MN), outlined an Affordable Care Act (“ACA”) alternative for states that opt out of running a federal exchange. The proposal, which was published... READ MORE

House Ways and Means Committee Advances Medicare Program Integrity Bill On Thursday, February 26, the House Ways and Means Committee approved four bills, including a broad Medicare anti-fraud bill and a measure that would require hospitals to notify patients when they are considered to be under observation status.  The anti-fraud bill (H.R. 1021) was... READ MORE

CMS Delays Final Rule on Collecting Medicare Overpayments On Tuesday, February 17, CMS announced through the Federal Register that it will postpone until February 16, 2016 the implementation of a proposed rule that would require Medicare providers under Parts A and B of Title XVIII to return overpayments within 60 days. CMS first proposed the rule, which... READ MORE

Six- to Nine-Month SGR Patch Likely as Deadline Looms With a March 31 deadline approaching, congressional committees continue to meet and discuss how to fix the Medicare Sustainable Growth Rate (“SGR”) physician payment formula. However, health care industry lobbyists now agree that a six-to nine-month “patch” of the existing formula is more likely than lawmakers... READ MORE

Bipartisan Stark Law Correction Bill Reintroduced On February 5, Reps. Charles Boustany (R-LA) and Ron Kind (D-WI) reintroduced the Stark Administrative Simplification Act (H.R. 376). The legislation corrects the disproportionate penalties a hospital can incur under the Stark Law for having an unwritten, unsigned or lapsed agreement that is otherwise compliant with federal fraud... READ MORE

Medicare Proposes Shift in Payments On Monday, January 26, HHS Secretary Sylvia Burwell announced a proposed shift in the way health care providers are paid by expanding the use of alternative payment models.  According to the announcement, HHS has set a goal of tying 30% of traditional fee-for-service Medicare payments to quality or value... READ MORE