The Senate last night approved a bill to repeal Medicare’s sustainable growth rate formula, hours before double-digit payment cuts to physicians were set to take effect. Passage of the legislation, which now heads to President Obama for his signature, generated significant print and online media coverage and is portrayed as a major bipartisan achievement for Congress. The New York Times (4/15, A16, Pear, Subscription Publication) reports that the Senate “on Tuesday approved sweeping changes in the way Medicare pays doctors, clearing the bill for President Obama and resolving an issue that has bedeviled Congress and the Medicare program for more than a decade.” Senators voted 92 to 8 to repeal Medicare’s sustainable growth rate formula and also extend the Children’s Health Insurance Program for two years. Without action by Congress, physicians “would have faced a 21 percent cut in Medicare fees on Wednesday or Thursday.” The Times adds that “the American Medical Association lobbied strongly for the bill, demanding that Congress ‘fix Medicare now.’” USA Today (4/15, Kelly) notes the Senate passed the bipartisan deal “just hours before that cut was to take effect” at midnight. President Obama is expected to “quickly sign the bill into law.” Before the bill’s passage, the AP (4/15, Fram) reports, senators “were voting on amendments, three from each party, that seemed sure to lose but let lawmakers demonstrate their disapproval of provisions they opposed.” A Democratic proposal to extend CHIP for four years fell short of the 60 votes necessary to prevail, while conservatives tried to force Congress to pay for the entire $214 billion package. The Hill (4/15, Carney) reports in its “Floor Action” blog that senators rejected an amendment proposed by Sen. John Cornyn (R-TX) that would have repealed the ACA’s individual mandate to pay for the legislation. The Hill (4/15, Ferris) notes that had senators approved any of the amendments, the legislation would have been sent back to the House. Modern Healthcare (4/15, Subscription Publication) reports that “the American Medical Association sent a letter to Senate leaders Tuesday urging passage of the bill without adopting” any amendments. According to the Washington Post (4/15, Debonis), the SGR bill was praised by congressional leaders “as a bipartisan triumph for both removing a yearly headache from the legislative calendar but also by implementing modest reforms to Medicare, including future incentives for doctors to deliver better care as well as premium hikes for the wealthiest Medicare recipients.” Senate Majority Leader Mitch McConnell (R-KY) said in a statement, “Instead of kicking this important Medicare payment issue down the road again, a strong bipartisan majority in Congress voted to finally solve the problem and ensure that seniors on Medicare don’t lose access to their doctors.” The Wall Street Journal (4/15, Hughes, Subscription Publication) reports that under the legislation, physicians will receive a 0.5 percent pay increase starting in July, followed by additional 0.5 percent annual pay raises through 2019, before the government implements new incentives for physicians to adopt alternative payment models. According to the Los Angeles Times (4/15, Levey), groups “that had pushed for years to change the payment system” were pleased with the bill’s passage. AMA Wire (4/15) says the legislation “takes an important first step by eliminating the SGR formula,” adding that the American Medical Association “will remain vigilant in working to ensure that implementation bolsters the sustainability of physician practices and empowers physicians to provide the best possible care for patients.” AMA Executive Vice President and CEO James L. Madara, MD, said in a statement, “Passage of this historic legislation finally brings an end to an era of uncertainty for Medicare beneficiaries and their physicians—facilitating the implementation of innovative care models that will improve care quality and lower costs.” Meanwhile, the AMA “pushed back” against a recent report from CMS’ chief actuary that said the SGR bill’s annual payment updates would create long-range funding problems, Bloomberg BNA (4/15) reports. AMA President Robert Wah, MD, said in a statement that the report “presents an argument for maintaining the status quo that is illogical, flawed and dangerous for patient access to high quality health care.” Dr. Wah added that the legislation “is far better than current law and will ensure the sustainability of the Medicare program.”
