The historic compromise legislation passed by the Senate this week will overhaul the way Medicare pays physicians and will create new systems to reward high-performing doctors.
The bill, which drew unusual bipartisan support in both chambers of Congress, also includes new funding for state insurance programs for children and for thousands of community health centers nationwide.
Key provisions of the legislation include:
-- No more “doc fix.” Gone is an arcane Medicare fee system that has been widely criticized almost since it was created in 1997. The system, known as the Sustainable Growth Rate formula, was designed to control Medicare spending by limiting annual increases in physicians' reimbursements.
But year after year, as automatic cuts threatened to slash Medicare fees, physician groups warned of dire consequences for medical practices and patients, setting off a scramble in Congress to override the mandated limits. The annual dash became known as the “doc fix.”
This month, fees would have been cut 21% had Congress not acted.