The biggest obstacle to fixing the flawed system that Medicare uses to pay physicians is the price tag. The CBO estimates that repealing the current payment formula would cost $116.5 billion over 10 years.
The momentum for real legislative action was growing at the time. The next year, the Senate Finance and Budget committees and the House Ways and Means and Energy and Commerce committees all held hearings to brainstorm ways to get rid of the SGR.
In addition, Pennsylvania Democratic Rep. Allyson Y. Schwartz and Nevada Republican Rep. Joe Heck introduced a bill to repeal it and begin a series of demonstration programs to find a replacement system.
In early 2013, members of Energy and Commerce and Ways and Means took a big step by outlining a framework to replace the SGR system. After receiving provider input and holding hearings on the framework, Energy and Commerce approved its version in July. In October, Ways and Means introduced a somewhat different joint framework with Finance.
That progress — the most in years — has both stakeholders and lawmakers excited.
“There is unprecedented bipartisan momentum in Congress for signing a bill into law that will repeal the broken Medicare payment formula,” Hoven said.
American College of Physicians President Molly Cooke said in a statement that her group is “greatly encouraged” by the committees’ progress.
Provider groups have also praised many of the changes made to the Senate Finance and House Ways and Means committees’ joint framework.
What remains to be seen is whether — and how quickly — members can take the different proposals, combine them and find acceptable offsets to get a final measure to the president’s desk.