Congress has until March 31 to repeal Medicare's sustainable growth rate (SGR) formula that calls for an almost 24 percent cut in Medicare payments this year, according to congressional staffers who were panelists at HIMSS14. A bipartisan group of House and Senate members introduced a bill last month that would not only repeal the "broken" and flawed" SGR formula, they say, but also includes important health information technology provisions.
The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 "does a lot of good things for health I.T.," remarked Mitchell Vakerics, legislative counsel for Rep. Renee Ellmers (R-N.C.), who sits on the House Energy and Commerce Subcommittee on Health, Communications and Technology.
Starting in 2018, the proposed legislation would establish a "streamlined" incentive payment program that consolidates the Physician Quality Reporting System, the Value-Based Payment Modifier, and Meaningful Use EHR incentive program into one that increasingly rewards quality and value.
"Right now, we have several different channels through which we measure quality and what we want to do with the SGR bill is to use the opportunities we have in quality reporting to tie all those tracks together in quality-based payment rates going forward and giving the opportunity for industry folks to take part in alternative payment models," said Nick Uehlecke, legislative assistant for the majority staff of the House Ways and Means Committee.
Called the Merit-Based Incentive Payment System (MIPS), the program would assess the performance of eligible professionals (EPs) in four categories: quality, resource use, EHR meaningful use and clinical practice improvement. Under MIPS, EPs would potentially receive both positive and negative payment adjustments based on their overall performance in the four categories.
The Medicare EHR program would continue as currently structured through 2017 and requirements and certified systems would also continue under the new MIPS program. EPs who report quality measures through certified EHR systems for the MIPS quality category would be deemed as meeting the meaningful use clinical quality measure component.
All EHRs would be required under the proposed legislation to achieve interoperability by 2017, said Stacy Cline, director of oversight and investigations for Republicans on the Senate Committee on Health, Education, Labor and Pensions. The bill also prohibits providers from deliberately blocking information sharing with other EHR vendor products.
Among other groups, the American Medical Association and the American Academy of Family Physicians have voiced their support for the proposed legislation and are urging Congress to pass it into law by March 31. The legislation, H.R. 4015 in the House and S. 2000 in the Senate, is available at congress.gov.
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