Budget Deal Lacks SGR Fix, Pay Bump Extension

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the Neurology Advisor take:

The Senate has passed the $1.1 trillion budget deal which fails to address the issues that many physicians have with Medicare and Medicaid.

The budget bill lacks two major components for physicians: reparation to the sustainable growth rate (SGR) formula for physician reimbursement under Medicare and an extension of the current pay bump for physicians who see Medicaid patients.

Physician organizations were especially disappointed that the SGR was not fixed, noting that the legislation to fix it had been generally agreed upon. Congress estimates that the price of repealing the SGR currently stands at approximately $140 billion, which is the lowest it has been in a while.

According to David Fleming, MD, president of the American College of Physicians, Congress faces two choices: repeal the SGR and deal with the cost, or make a substantial cut in reimbursement for physicians that will eventually negatively affect patients.

Anders Gilberg, senior vice president for government affairs at the Medical Group Management Association’s (MGMA) Washington office, also voiced concern about the lack of an extension to the Medicaid pay bump. If Medicaid rates are not on par with Medicare, the disparity will likely discourage physicians from seeing Medicaid patients. He said that 15 states have currently planned to sustain the pay bump, but the threat of 30% to 50% fee cuts in other states remains.

The budget bill was passed in the Senate on Saturday by a vote of 56-40.

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Budget Deal Lacks SGR Fix, Pay Bump Extension

The Senate has passed the $1.1. trillion budget deal, clearing the way for President Obama to sign a measure that has disappointed many physician groups.

The budget bill, which was passed by the House on Thursday, passed the Senate Saturday night by a vote of 56-40. The bill lacks any fix to the widely hated sustainable growth rate (SGR) formula for physician reimbursement under Medicare. Also missing in action: an extension of the current pay bump for primary care physicians who see Medicaid patients.

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