For sustainable growth rate, Congress weighs last year's proposal ahead of deadline

The deadline for Congress to act on the sustainable growth rate is fast approaching, with most policy watchers agreeing another “doc fix” override is likely.

If Congress doesn’t act, starting on April 1, physicians who accept Medicare would get a 21.2 percent pay cut as mandated by the sustainable growth rate formula for Medicare payment.

Congress is attempting to repeal its own SGR formula, using last year’s proposals as the framework, according to Health Affairs, a leading journal of health policy.

In 2014, Congress agreed on legislation to replace SGR, but was unable to find a way to pay for it. The cost to taxpayers over the next 10 years would be an estimated $174.5 billion.

The Congressional Budget Office has come up with the budgetary effects of alternative policies, including estimates for several replacement and short-term plans. The House Energy and Commerce Committee hearings have identified a range of bipartisan plans.

The starting date of these policies would be April 1.

The current SGR formula was intended to constrain Medicare Part B physician spending by adjusting the annual fees. Congress has averted these physician fee cuts 18 times since 2003 by overriding the SGR.