MSDC advocates on national issues of importance to physicians in the metropolitan Washington area and their patients. We collaborate with the American Medical Association (AMA), national specialty societies, other state medical associations and other medical organizations, collectively referred to as our Federation Partners, to secure passage of legislation addressing medical liability, Medicare payment reform, antitrust, public health and a wide range of critical issues.
Medicare Access and CHIP Reauthorization
The Medical Society supports American Medical Association advocacy regarding the funding of quality measure development and technical assistance to small practices under the “Medicare Access and CHIP Reauthorization Act of 2015,” or MACRA. Public Law 114-10. Timely and targeted funding for these two activities is critical to the success of physician payment reform
SUSTAINABLE GROWTH RATE (SGR) FORMULA
Congress and White House Agree to Eliminate SGR
On April 16, 2015, President Obama signed legislation eliminating Medicare's Sustainable Growth Rate formula. The legislation, H.R. 2, the "Medicare Access and Chip Reauthorization Act
" (MACRA) received strong bipartisan support from both chambers of Congress and avoided double-digit payment cuts to physicians. Read an AMA summary of how the newly signed legislation compares to the previous Medicare payment system
In response, to Congress' passage of the legislation, American Medical Association President Robert M. Wah, MD, issued a statement, saying that "The new legislation removes much of the instability and uncertainty that long has plagued the Medicare payment system so our practices can be here to serve our patients."
The Medical Society would like to thank the many physicians who contacted their members of Congress to help end the fundamentally flawed Medicare payment formula and petition for more sustainable healthcare for our nation's seniors. The Medical Society of the District of Columbia will collaborate with the American Medical Association and other state medical and specialty societies to ensure that the law's implementation supports the sustainability of physician practices and empowers physicians to provide the best possible care for patients.
Communication from the Centers for Medicare and Medicaid Services, April 15, 2105
Attention Health Professionals: Information Regarding the Medicare Access and CHIP Reauthorization Act of 2015
On April 14 , 2015, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015; the President is expected to sign it shortly. This law eliminates the negative update of 21% scheduled to take effect as of April 1, 2015, for the Medicare Physician Fee Schedule. In addition, provisions allowing for exceptions to the therapy cap, add-on payments for ambulance services, payments for low volume hospitals, and payments for Medicare dependent hospitals that expired on April 1 have been extended. CMS will immediately begin work to implement these provisions.
In an effort to minimize financial effects on providers, CMS previously instituted a 10-business day processing hold for all impacted claims with dates of service April 1, 2015, and later. While the Medicare Administrative Contractors (MACs) have been instructed to implement the rates in the legislation, a small volume of claims will be processed at the reduced rate based on the negative update amount. The MACs will automatically reprocess claims paid at the reduced rate with the new payment rate.
No action is necessary from providers who have already submitted claims for the impacted dates of service.
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According to the American Medical Association (AMA), Medicare should begin processing claims April 15, 2015, "for services provided in April at the rates that were effective before the 21 percent cut was scheduled to take effect. Under the provisions of H.R. 2, the fee schedule conversion factor will be increased by 0.5 percent on July 1, 2015, and by another 0.5 percent on January 1, 2016."
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The Medical Society will share additional information that is important to physician practices as it becomes available. You may also email the Medical Society with questions or comments.
MEDIA COVERAGE OF H.R. 2:
Read MSDC's Latest News for additional coverage of the SGR repeal.