Senate Bill to Nix SGR Formula Faces Long Odds

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As an eye surgeon, Sen. Rand Paul, MD (R, Ky.), knows the problems associated with the sustainable growth rate (SGR) formula that helps determine Medicare physician pay. However, eliminating the SGR may not have been his only motivation in introducing the Access to Physicians in Medicare Act (S. 3337), and that makes it a non-started with Democrats.

In the unlikely event the bill got passed, it would pay for a permanent SGR fix by defunding the Patient Protection and Affordable Care Act (PPACA, aka "Obamacare"). The legislation, which was introduced June 25, would repeal the Medicaid expansion and insurance subsidy payments provided by the health reform law. As a result of this and other factors, GovTrack.us gives it only a 1% chance of passing.

In contrast, H.R. 5707: The Medicare Physician Payment Innovation Act of 2012, that was introduced by Rep. Allyson Schwartz (D-Pa.) on May 9th is more vague on how the removal of the SGR formula for calculating payments would be accomplished. Instead, it largely pushes the responsibility for developing an alternative way of calculating payments onto Health and Human Services.

Perhaps because of the vagueness, H.R. 5707 is more well liked by medical groups. It's introduction was "applauded" by the American College of Physicians (ACP) . But it does little to improve its chance of passing. It has only a 2% chance of passing the House, according to GovTrack.us.