Medicare Compliance & Reimbursement

Physician Notes; New Health Care Legislation May Benefit Practices, But Fails to Address SGR Formula

PPACA makes sweeping changes to the healthcare system but Medicare pay freeze not extended yet.

If you were waiting for the healthcare reform law to bring sweeping changes to the way your Medicare payments are calculated, you'll have to be patient.

The Patient Protection and Affordable Care Act,which President Obama signed on March 23, includes sweeping changes to the U.S. healthcare system, but does not change the sustainable growth rate (SGR) formula or extend the Medicare pay freeze, which is currently set toexpire on March 31.

Although primary care physicians and mental health practitioners will most likely see a Medicare payment boost from the new health care legislation, some practices were hoping that a permanent change to the SGR would also be included in it.

Senator Judd Gregg (R--"NH) introduced an amendment to the reconciliation bill on March 24 that would extend the current Medicare physician reimbursement formula for three years, according to a March 24 news release on Gregg's Web site. Funding for the three-year extension would come from savings found in the Patient Protection and Affordable Care Act, Gregg noted.