An End to the Doc Fix for Medicare and TRICARE?

Working with the House Committee on Ways and Means, leaders from the House Energy and Commerce Committee have unveiled draft legislation that would repeal the current Sustainable Growth Rate (SGR) system and replace it with a fair and stable system of physician payments in the Medicare program.  Enacted in 1997 as part of the “Balanced Budget Act,” the SGR is a continued concern for physicians who serve Medicare beneficiaries and for the beneficiaries themselves.  Because payments to doctors who treat TRICARE beneficiaries are tied to Medicare, it also affects active duty, reserve, and retired military personnel and their families.  Congress had implemented a temporary “doc fix” to prevent substantial Medicare reimbursement rate cuts, which could result in fewer physicians willing to serve Medicare/TRICARE patients.  This draft legislation would replace the current SGR with an enhanced fee-for-service.  Although the draft legislation provides a clearer picture of the proposed new payment system, it does not address how to pay for the cost of repealing the current payment system.  What’s next:  Health Subcommittee Chairman Joe Pitts, R-Penn., plans to hold a markup of the legislation next month.