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Special Report: March 26, 2015

SGR Repeal Bill Passes: Includes CAP Provision to Address Quality Reporting

The College of American Pathologists (CAP) applauds the House for its passage of HR 2, the Medicare Access and CHIP Reauthorization Act, the bipartisan, bicameral legislation which includes the CAP secured language that gives pathologists much needed flexibility 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.

For over a decade, the CAP has advocated that repealing the broken SGR formula will stabilize the overall Medicare payment system. In addition to eliminating the Sustainable Growth Rate (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.

HR 2 did not include the closure of the Stark self-referral loophole protecting physicians who refer anatomic pathology (AP) services to laboratories in which they own or in which they have a financial interest, as a means of partially offsetting the $200 billion cost of the bill. The CAP, along with its Alliance for Integrity in Medicare (AIM) partners, will continue to call on Congress to close the Stark self-referral loophole.

The Medicare sustainable growth rate (SGR) repeal bill passed by a vote of 392 to 37. A summary of the bill's provisions is available at the House Ways and Means Committee website.

A vote in the Senate is expected to occur in the near future.

The CAP will continue to keep members informed on the latest SGR developments through STATLINE.

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