Saturday 28 September 2013

Fiscal 2014 Budget Offers Sequester and SGR Repeal

If the recent physician cuts have been giving you sleepless nights, there’s a ray of hope. Rather than facing more cuts, physicians will now be on the receiving end of some federal largesse.

On April 9, 2013, President Barack Obama released a budget proposal for fiscal 2014. The proposed budget assumes the repeal of Medicare's sustainable growth rate (SGR) formula and the 26.5% physician pay cut that it would trigger.

Sen. Patty Murray, chair of the Senate budget committee, presented his budget proposal, which factors in the $1.8 trillion cost of maintaining Medicare rates at their present level over a course of 10 years.

This budget also withdraws sequestration — the automatic, across-the-board cuts — that includes a 2% cuts in Medicare reimbursement for physicians. These cuts were scheduled for April 1 this year (Read our last month’s news story “Sequestration Budget: Brace yourself for 2% Cuts Starting April 1” on codinginstitute.com). The proposed budget gives out nearly $1 trillion to replace the sequester cuts.

The budget also offers a deficit-neutral reserve fund that will replace the SGR with a new payment plan. Under this plan, physician pay rates would be frozen at their present level.

AMA President Jeremy A. Lazarus, MD, said in a statement, "We are pleased that President Obama's 2014 budget recognizes the need to eliminate the broken Medicare physician payment formula known as the SGR and move toward new ways of delivering and paying for care that reward quality and reduce costs. The president's proposals align with many of the principles developed by the AMA and 110 other physician organizations on transitioning Medicare to include an array of accountable payment models." You can go to http://www.ama-assn.org/ama/pub/news/news/2013-04-10-statement-on-presidents-budget.page to read the statement given by Dr. Lazarus in its entirety.

Although Medicare spending would come down substantially, the cuts would also come at a cost — and will have maximum effect on hospitals, drug companies, nursing homes, and wealthy seniors, who would ultimately end up paying considerably higher premiums. The budget would reduce the deficit by raising an additional $580 billion in revenue over a period of 10 years; especially by closing tax loopholes and making some tax-code changes for the wealthy class.
"While eliminating the SGR would be a step forward, the budget takes a step backward by aiming to achieve more savings through the Medicare Independent Payment Advisory Board (IPAB), which would set another arbitrary spending target and rely solely on payment cuts to reach it," Dr. Lazarus further said in his statement. "The AMA strongly supports bipartisan proposals to eliminate this panel."

The plan offered by Senate is also similar to the president's plan, and it offers to reduce the deficit by $1.85 trillion over a period of 10 years with a combination of increasing revenue and reducing spending.

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