Medicare advisory group recommends SGR repeal, catch-up for PCP

By:  Annette M. Boyle, – Modern Medicine:

The Medicare Payment Advisory Commission (MedPAC) has voted 15-2 to recommend to Congress a plan that repeals the sustainable growth rate (SGR) formula and replaces it with a mechanism to keep rates steady for primary care physicians (PCPs) over the next decade while cutting payments to specialists.

“The [SGR] system—the current formulaic system for updating fee-schedule payments—is fundamentally flawed,” MedPAC staff wrote in a brief for the committee. “Although eliminating it carries a high budgetary cost, leaving it in place is considered by many to be even more problematic.”

Currently, the SGR formula, which is strongly opposed by primary care groups, calls for a 29.5% cut in physician payments starting January 1. Although Congress has repeatedly passed stop-gap legislation to prevent the cuts, it hasn’t developed any other system.



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