April 14, 2015

Senate passes permanent repeal of SGR

This evening the Senate joined the House in passing a permanent repeal of the SGR, averting the 21% payment reduction that was to take effect on April 1, 2015.  The bill now heads to the desk of the President, who has issued a formal statement supporting the bill, indicating that he would sign it.

The bill provides for a 0.5% payment update for five years before offering additional incentives to providers to use alternative, value-based payment models.  It consolidates three existing value-based programs (EHR Meaningful Use, PQRS, and Value-based Modifier) into a single program. The bill would also incentivize the development and participation in new, value-based payment models.

It is not clear how quickly CMS will be able to reprogram the claims processing computers to prevent claims scheduled to be paid tomorrow from being subject to the SGR cut.  We expect CMS to make a quick announcement on their plans now that the SGR will be repealed.  It is possible for CMS to continue to hold any claims for claims date of service on or after April 1, but at this time we do not know whether CMS will exercise this discretionary authority.  We will keep you updated as we learn more.

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