payment reform

AAFP Declares Victory for FPs as Senate Fully Repeals SGR

Family physicians triumphed Tuesday night as the Senate removed a longstanding obstacle to improved patient care by repealing the Medicare sustainable growth rate (SGR), the controversial formula that had threatened to cut physician payments for years.

A look at key parts of sweeping bill changing how Medicare pays doctors

The historic compromise legislation passed by the Senate this week will overhaul the way Medicare pays physicians and will create new systems to reward high-performing doctors.

The bill, which drew unusual bipartisan support in both chambers of Congress, also includes new funding for state insurance programs for children and for thousands of community health centers nationwide.

Key provisions of the legislation include:

News Author: 
Noam Levey

Hours from deadline, bipartisan Medicare bill heads to White House

America's doctors can rest easy: Not only has Congress ensured they will be paid in full for the services they render to Medicare patients, it has ended the yearly ritual putting that in doubt.

The Senate voted 92-8 to approve a long-term "doc fix," as the legislation adjusting Medicare fees has long been known, less than three hours before federal officials would have reduced payments to health-care providers by 21 percent. President Obama has indicated that he will sign the bill, which also extends the federal Children's Health Insurance Program, a key Democratic priority.

News Author: 
Mike DeBonis

PCPCC Praises Congress for Real Payment Reform and the End of SGR

April 14, 2015

CONTACT: Caroline DeLaney | (352) 258-0090 

News Author: 
Patient-Centered Primary Care Collaborative

Senate Searches for Medicare ‘Doc Fix’ Amendments

With a vocal opposition that has grown over the two-week recess, Senate leadership is looking for a path forward on legislation that would strike down Medicare’s unpopular Sustainable Growth Rate formula.

The legislation passed the House 392-37 last month with an unexpectedly bipartisan vote. Despite a ticking clock – the Centers for Medicare and Medicaid Services will start processing claims with cut payments on Wednesday – the bill could face a rockier road in the Senate.

News Author: 
Meghan McCarthy
Jon Reid

Senate tees up votes on $200B Medicare deal

The Senate is poised to vote Tuesday on a handful of amendments to a roughly $200 billion Medicare deal, according to three people familiar with the negotiations.

Senate leaders are expected to enforce limited debate on the amendments, creating the high bar of 60 votes for passage, according to a lobbyist familiar with the talks. 

“We don’t want to amend this bill to death; we want three simple amendments,” Minority Leader Harry Reid (D-Nev.) said Monday from the Senate floor.

News Author: 
Jordain Carney
Sarah Ferris
Peter Sullivan

'Doc fix' still on track despite two weeks to lose steam

Two weeks have passed since the Senate left town without taking action on legislation to permanently repeal Medicare's sustainable growth-rate formula for paying doctors. That left the deal in limbo and disappointed healthcare advocates who thought that a permanent “doc fix” was imminent.

But with Congress set to return on Tuesday, no serious threats to the deal have emerged and the Senate appears poised to end the decade-plus cycle of short-term fixes.

News Author: 
Paul Demko

Patient-Centered Medical Home Complements Healthcare Reform

The patient-centered medical home (PCMH) model challenges primary care providers to raise the bar on care coordination, population health management, clinical analytics, and access to care, but healthcare organizations that undertake these important quality transformations are usually left to foot the bill themselves.  In a reimbursement landscape that remains, for the most part, rooted in fee-for-service payment, the incentive to pay out of pocket for these massive and costly changes can be hard to find.

News Author: 
Jennifer Bresnick

Feds: Senate has two days to act, or the docs get it

House members spent a lot of time last week congratulating themselves for passing a permanent "doc fix" -- that is, an end to the yearly ritual of readjusting the rates Medicare pays to health care providers in order to avoid drastic cuts that could cause them to stop treating elderly patients.

News Author: 
Mike DeBonis

Senate has new deadline to avoid doctors’ Medicare cuts

Congress will get a little extra time to prevent a threatened 21 percent cut in Medicare payments to doctors.

Technically, the cut was to take effect Wednesday.

But the Department of Health and Human Services said it will hold off processing claims at the lower rate until April 15.

The House has overwhelmingly passed a bill to repeal the 1990s budget formula that requires the Medicare cuts. But the Senate left on its spring break before taking action. President Barack Obama says he would sign the House bill.


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