Congressman Michael C. Burgess has introduced H.R. 1470, the “SGR Repeal and Medicare Provider Payment Modernization Act of 2015,”which repeals the Sustainable Growth Rate (SGR) formula and replaces it with a long-term sustainable plan. The bipartisan bill is an important advancement in long-fought efforts to comprehensively reform the Medicare system in order to promote higher quality care for seniors, physicians, and providers.
The legislation will prevent harmful cuts to Medicare providers that threaten seniors’ access to care. Ultimately, the agreement will preserve Medicare’s integrity by putting an end to costly year-by-year “patches,” and provide reassurance to seniors with access to quality care they deserve.
“As a doctor, I know first-hand just how destructive the SGR formula has been to America’s seniors and their providers,” Burgess said. “Finally, after unparalleled progress in recent years, both sides of the aisle have begun to understand that the long-term solvency of our Medicare system depends on taking this fight head-on together.
“Permanently repealing the SGR puts medical experts back in charge of measuring quality care, stamps out unnecessary barriers between seniors and their doctors, and begins to address the single largest driver of our debt. This is a clear opportunity to do what is right for the American people, and a paramount first step toward accomplishing real – meaningful – entitlement reforms.”
The bill was introduced by a bipartisan coalition consisting of Rep. Michael C. Burgess, M.D (R-TX), House Energy and Commerce Committee Chairman Fred Upton (R-MI), House Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ), House Energy and Commerce Health Subcommittee Chairman Joe Pitts (R-PA), Rep. Charles Boustany (R-LA), House Energy and Commerce Health Subcommittee Ranking Member Gene Green (D-TX), House Ways and Means Committee Chairman Paul Ryan (R-WI), House Ways and Means Committee Ranking Member Sander Levin (D-MI), House Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX), and Ways and Means Health Subcommittee Ranking Member Jim McDermott (D-WA).
Background: The legislation repeals the fundamentally flawed SGR formula, which has forced 17 short-term costly patches over the past decade in order to prevent devastating Medicare reimbursement rate cuts. The formula will be replaced with a system focused on quality care and accountability. The plan will:
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Repeal the SGR and end the annual threat to seniors’ care, while instituting a 0.5% payment update each year for five years. -
Improve the fee-for-service system by streamlining Medicare’s existing web of quality programs into one value-based performance program. It increases payment accuracy and encourages physicians to adopt proven practices. -
Incentivize the use of alternative payment models to encourage doctors and providers to focus more on coordination and prevention to improve quality and reduce costs. -
Make Medicare more transparent by giving patients more access to information and supplying doctors with data they can use to improve care.
Support from the House GOP Doctors Caucus:
“The Doctors Caucus is proud to unite behind this important legislation,” said co-chairs Roe and Fleming. “Repealing and replacing this flawed formula is good for doctors and patients, and we’re glad to see House leaders working together on a bipartisan basis.” They continued, “We’d like to thank our good friend and colleague, Dr. Burgess, for his years of hard work and determination on this issue. Mike is a respected voice in the Doctors Caucus and we are grateful for his continued leadership.”
Additional supporters include more than 750 state and national medical societies, and the millions of patients they serve, have announced support for SGR repeal legislation to be passed before the March 31 deadline. Some supporters include:
