Monday, April 14, 2014

Congress Fails to Repeal SGR- Postpones 24% Payment Cut for a Year

The House and the Senate voted in favor of the "Protecting Access to Medicare Act of 2014." The legislation stops the payment cut of 24% that would have occurred on April 1.  The House passed the legislation by a voice vote on March 27. The Senate passed its identical version of the House bill on March 31 by a vote of 64 to 35. MSNJ, AMA, and virtually all of organized medicine opposed this bill because it failed to repeal the flawed SGR payment formula that will continue to result in annual payment cuts. Over the past year, bipartisan, bicameral policy was developed that would have eliminated the SGR and replaced it with a Medicare payment reform. Congress failed to seize this historic opportunity. Key terms of the legislation follow

  • Extends the 0.5% payment update through the end of 2014.
  • Provides a freeze between January 1, 2015 and March 2015
  • Delays implementation of ICD-10 for at least one year through October 1, 2015.



  • Practices Must Start Using the New CMS 1500 Claim Form by April 1  
    The CMS-1500 Claim Form has been revised to more adequately support the use of the ICD-10 diagnosis code set. The form will now give physicians the ability to indicate whether they are using ICD-9 or ICD-10 diagnosis codes.

    Medicare will only accept the revised version of the form starting April 1, 2014, as will many other payors.