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This week’s headline:

SGR repeal bill offers light at the end of the payment reform tunnel

The SGR Repeal and Medicare Provider Payment Modernization Act of 2014, HR 4015/S 2000, would repeal the sustainable growth rate formula (SGR) and increase physician payments by 0.5 percent each year for five years under a new bipartisan agreement. While the American Academy of Dermatology Association (AADA) offered its support for the bipartisan legislation, it also expressed its concerns regarding certain provisions and their potential impact on patient access to dermatologic care as well.

Positive provisions
Over the past year, the AADA sent eight separate letters commenting on various payment reform proposals and advocated before Congress and key lawmakers on several issues. As a result of the AADA advocacy efforts, the reform bill:

Repeals Medicare’s broken SGR formula.
Replaces scheduled Medicare payment cuts with five years of positive payment updates.
Streamlines existing programs (PQRS, Value-Based Modifier, EHR meaningful use) into one incentive-based payment program through which all physicians will have the opportunity to qualify for additional bonus incentive payments.
Includes physician societies in the development of performance measures.
Includes the Standard of Care Protection Act, which provides important liability protections for physicians.

Provisions of concern
However, in its support letter the AADA highlighted concerns with the implementation of the legislation, specifically, the impact of additional directives for the Centers for Medicare and Medicaid Services (CMS) with regard to determining services that are potentially misvalued or overvalued. Given the significant work that CMS and the AMA Specialty Society Relative Value Update Committee (RUC) have already done to identify both misvalued and overvalued services, the AADA recommended that CMS and the RUC continue their work before additional initiatives are put into place.

Next steps: Paying for Medicare payment reform
It is estimated that Medicare payment reform could cost more than $120 billion. As the legislative process moves forward, the AADA emphasized that it is essential that any provisions to offset the cost of reform do not work counter to the practice and delivery of high quality dermatologic care to patients.

Get involved
The AADA is calling on all members to log on to the AADA Dermatology Advocacy Network and submit a letter urging Congress to repeal and replace the SGR, and preserve dermatologists’ ability to provide the full range of care and services their patients depend on them to provide.

The AADA has been actively engaged in the efforts to reform the Medicare physician payment system, and will continue to provide updates as more information becomes available. Read more about Medicare payment reform. For more information, contact Shawn Friesen at sfriesen@aad.org.

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