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Update: House Passes “Doc Fix” Bill

Posted in Legislation and Public Policy, Medicare and Medicaid, Reimbursement Matters

On March 26, the U.S. House of Representatives voted to pass H.R. 2, the Medicare Access and CHIP Reauthorization Act (better known as the “Doc Fix Bill”), by a vote of 392 to 37. The bill, which was introduced in the House on March 24, is intended to permanently repeal the sustainable growth rate (SGR) formula used to calculate changes to physician fee schedules for Medicare payments.

Under H.R. 2, the SGR will be replaced with annual payment increases of 0.5% beginning later this year through 2019. Payments will then be held at the 2019 rate through 2025 and begin increasing again in 2026. From 2019 on, the bill provides for merit-based bonus payments for providers based on their use of electronic health record systems and new patient care models.

The bill also makes numerous changes to Medicare anti-fraud provisions, delays enforcement of Medicare’s “two midnight” rule for inpatient hospital admissions, implements stricter rules for durable medical equipment providers, and extends the Children’s Health Insurance Program (CHIP) and funding for community health centers, each for two years.

The bill must still be approved by the Senate and be signed by President Obama before it becomes law. The current “doc fix” deal was adopted by Congress in 2014 and is set to expire on March 31; however, the Centers for Medicare and Medicaid Services plans to take administrative steps to delay payment cuts until the Senate returns from a two-week recess and votes on the bill.

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