Today, the Medicare physician payment reform legislation was modified to include budget offsets, policy extenders, and other provisions and reintroduced by Rep. Michael Burgess, MD (R-TX) as H.R. 2, the “Medicare and CHIP Reauthorization Act” (MACRA).  Click here to view a section by section summary from the House Energy and Commerce and Ways and Means Committees.

The new bill replaces H.R. 1470, which was introduced last week. It builds on the bipartisan, bicameral SGR replacement policy negotiated last year.

What's Next?

The bill is scheduled for consideration by the House Rules Committee on Wednesday afternoon (3/25).  Floor debate is expected to occur Thursday morning, with a vote taking place early Thursday afternoon (3/26).

On Thursday, the Senate will be voting on amendments to the FY 2015 budget resolution, which cannot be interrupted for other business.  The budget votes are expected to continue well into the night, after which some action could occur regarding H.R. 2.

Since H.R. 2 is originating in the House, the breadth of support in the Senate is less certain.

If the Senate fails to pass the bill before adjourning for the two-week recess, a 21% Medicare physician payment cut will technically take effect on April 1.  Because Medicare is required by law to hold claims for two weeks prior to issuing payment, physicians would not actually experience any cuts before April 14 — the day after Congress returns.

It's Not Over

The AMA continues to update material on the web site FixMedicareNow.org, which provides links for you to contact your legislators:

It is vitally important for medicine to secure a strong House vote to maintain momentum that can carry the bill through the Senate. All CSMS members are encouraged to keep up the Congressional advocacy efforts.

The AMA continues to update material on the web site FixMedicareNow.org, which provides links for you to contact your legislators:

• Call your U.S. representative and senators using the AMA’s toll-free Physicians Grassroots Hotline: (800) 833-6354.


• Send an urgent email to your lawmakers reinforcing the need for SGR repeal now – Click Here!


• Contact key legislators still undecided on this most critical issue directly through their own social media channels, and share with your own Facebook friends and Twitter followers as well – Click Here!

The details

Click here to view a section by section summary from the House Energy and Commerce and Ways and Means Committees.

Additional H.R. 2 provisions include:

• The work GPCI floor was extended through 2017.


• The therapy caps exceptions process was extended through 2017.


• The Qualifying Individual (QI) program that provides Part B premium support for low-income Medicare beneficiaries was extended permanently, as was the Transitional Medical Assistance (TMA) program that allows Medicaid recipients to maintain coverage for a year as they transition from welfare to work.


• Funds for Community Health Centers and the National Health Service Corps and the Teaching Health Center GME Payment Program were all extended through 2017.


• The Children’s Health Insurance Program (CHIP) was extended through 2017.


• For new enrollees beginning in 2020, Medigap plan coverage will be limited to costs above the amount of the Part B deductible.


• Income-related premiums for Medicare Part B and D under current law have been readjusted; those with incomes between $133,501 and $160,000 will increase from 50 percent to 65 percent, those with incomes at $160,001 and above will increase from 65 percent to 80 percent.


• The decision by the Centers for Medicare and Medicaid Services (CMS) to eliminate bundled payments for 10-day and 90-day global surgical services has been reversed; instead, CMS will collect data on these services beginning in 2017 to determine the accuracy of payment rates.