SGR Repeal Effort to Resume in House

Margaret Dick Tocknell, for HealthLeaders Media , July 16, 2013

Rep. Fred Upton (R-MI), who chairs the E&C and is credited with putting together the proposal, has let it be known that he wants it to go before the entire E&C Committee before Congress takes its annual August recess.

Capital Hill insiders do not expect the process to go quite that smoothly.

For one thing, the Republican House hopes to draw some Democratic blood by holding votes on repealing the employer and individual mandate provisions of the Affordable Care Act before the August recess. In addition, the E&C proposal isn't the only SGR repeal and replace legislation in the House.

Rep. Allyson Schwartz (D-PA) has already raised concerns about the E&C proposal. Her spokesperson, Greg Vadala, says the proposal doesn't do enough to reward quality over fee-for-service volume because the alternative payment model with its quality incentives is the "exception rather than the rule."

Schwartz has her own bipartisan SGR bill co-written with Rep. Joe Heck (R-NV). HR 574 (Medicare Physician Payment Innovation Act of 2013) has 34 co-sponsors. The bill has been stuck in committee since February, but Schwartz is hopeful that her approach, which includes a modified FFS element as a fall-back option, will gain traction. The bill includes a five-year period of payment stability that is popular with physicians.

Her pitch is that "she has a plan, laid out in legislative language, for how to get this done," says Vadala. Rep. Schwartz, a member of the powerful House Ways and Means Committee, also wants to "make sure that the priorities in her bill are part of the discussion," says Vadala.

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