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Special Report: April 15, 2015 

Senate Votes for SGR Repeal Bill With CAP Provision Addressing Quality Reporting

After strong advocacy urging Congress to repeal Medicare's sustainable growth rate (SGR), the Senate passed legislation to eliminate the broken payment formula and institute reforms supported by the CAP.

The CAP applauded the Senate for its passage of the Medicare Access and CHIP Reauthorization Act (HR 2), which included a CAP provision to give pathologists more options to meet requirements in Medicare's quality initiatives. The CAP language is tied to a new Merit-based Incentive Payment System (MIPS) created under the bill. The CAP provision in the permanent repeal bill gives the Secretary of Health and Human Services the flexibility to develop measures and activities for pathologists, and other physicians that don't have direct interaction with patients, to enable them to comply with Medicare's quality requirements under the new MIPS incentive program.

The Senate overwhelmingly approved of HR 2 by a vote of 92-8 on April 14. Senators had proposed six amendments to the bill but each failed to gain enough support. The House passed the SGR repeal bill on March 26 and President Obama is expected to sign the bill once it reaches his desk.

"The CAP secured language in the bill to ensure pathologists can more easily comply with Medicare's quality initiatives. We believe this provision will further help pathologists participate in Medicare's incentive programs by recognizing our contributions to high quality patient care," said CAP President Gene N. Herbek, MD, FCAP. "The SGR has destabilized the Medicare program for several years and caused constant uncertainty for physicians and patients. The CAP applauds the Congress for passing legislation that finally fixes the broken Medicare payment system and implements necessary reforms aimed at improving quality of care and the patient care experience."

The CAP advocated that repealing the broken SGR formula would stabilize the overall Medicare payment system. In addition to eliminating the SGR, the legislation increases Medicare payment rates slightly. The bill increases pay rates for physician services by 0.5% for the final six months of 2015 and then an additional 0.5% each year through 2019. The bill also provides financial incentives for providers participating in alternative payment models such as Accountable Care Organizations.