House of Representatives Seeks Input on Bill Scrapping 'Doc Fix'

Congress is preparing to eliminate the Sustainable Growth Rate (SGR, sometimes known as the “Doc Fix”) formula and wants to hear from healthcare providers and others if its proposed replacement is moving in the right direction.

The House of Representative Energy and Commerce Committee this week unwrapped its proposed legislation to eliminate the SGR and replace it ”with an improved fee for service system in which providers — working with the Secretary of Health and Human Services — develop quality measures that will lead to better care in a more efficient manner,” according a press release on the draft law. “In addition, providers will have the option of leaving the fee for service system and opt instead for new ways of delivering care that put an even greater emphasis on quality and efficient care.”

Committee leaders want feedback on their proposal and is seeking comments from those interested until June 10. Comments can be sent via e-mail to SGRComments@mail.house.gov. A hearing on the proposed legislation has been tentatively scheduled for June 5, according to the press release.

The SGR has been around since the 1990s, but beginning in 2003 Congress has reversed what has evolved into an automatic cut of physician’s reimbursement rates under Medicare. Those cuts continue to accumulate every year, and the reduction for 2013 would have been 26.5 percent, except once again Congress reversed it thanks to legislation contained in the Taxpayer Relief Act of 2012.

In February Reps. Allyson Schwartz (D-Pa.) and Joe Heck (R-Nev.) filed legislation to reverse the SGR. A day later Republican members of the Energy and Commerce Committee (including its Health Subcommittee) and the Ways and Means Committee and its Health Subcommittee released a proposed “framework” that would replace the SGR. At hearings in both the Senate and House, legislators all have agreed that the SGR must be eliminated.