SGR breaking news

Where did SGR come from?  

Enacted as part of the Balanced Budget Act of 1997, the SGR formula was put in place to limit increases in Medicare physician payments by linking payments to the gross domestic product — providing a target for Medicare spending that, if exceeded, would force a payment reduction on physicians the following year.

Why has SGR failed?

The SGR formula has proven to be anything but sustainable. The physician community argues that SGR underestimates the increase in volume and complexity of patient cases, and as a result the payment cuts are becoming more severe each year. For almost two decades, the house of medicine has been calling on Congress to repeal and replace the SGR.

On April 14, 2015, the Senate passed the Medicare Access and CHIP Reauthorization Act, clearing the way for a law that permanently repeals the SGR formula and restores global codes. Read more about this victory for dermatologists and the entire house of medicine.

See also:


AADA applauds repeal of SGR—Senate clears SGR repeal bill ending 13-year reimbursement rollercoaster

April 14, 2015: In a victory for dermatologists and the entire house of medicine, the Senate passed the Medicare Access and CHIP Reauthorization Act, clearing the way for a law that permanently repeals the sustainable growth rate (SGR) formula and restores global codes. The perennial fixes and patches posed great harm to patient access to care and deterred meaningful payment reform efforts. The restoration of global codes will alleviate additional co-pays for patients seeking follow-up care after a surgery or procedure. The President is expected to sign the bill into law very soon.

The unwavering support of the AADA membership in the form of thousands of emails, letters, calls and in-person visits to Capitol Hill each year helped secure this legislative milestone.

As the law begins implementation phase, it is essential that dermatologists remain vocal advocates. The law provides a pathway for physicians to lead in the development of new payment and care models. The AADA will continue to bring you the latest on the law’s implementation.

AADA praises House passage of SGR repeal; Victory in Senate possible with your help!

March 26, 2015: In a historic display of bipartisanship, the U.S. House of Representatives overwhelmingly voted to pass legislation that ends the dramatic, 13-year rollercoaster of patches and fixes for physician payment. The bill also reverses CMS’ decision to phase out the use of global codes for surgery – a win for patients who undergo procedures in a dermatologists’ office. The AADA supports the bill, and thanks its members who have joined the call to action for SGR repeal in sending over 2000 emails to Capitol Hill in recent weeks.

The victory is tempered by what still could be an uphill battle for passage in the Senate. The AADA needs all hands on deck from its members as there is no contingency plan if the bill fails to pass in the Senate. The clock is ticking, and time is running out. It takes two minutes to call or send a pre-drafted letter to your Senators through our Dermatology Action Network.

With your help – and in unity with colleagues from across the house of medicine – we can get SGR repeal passed once-and-for-all. 

Widespread bipartisan support for repeal of Medicare payment formula in this year

March 20, 2015: After years of riding the roller coaster of Medicare’s Sustainable Growth Rate (SGR) formula, many in Congress signaled support for action to address the formula before adjourning for the year. AADA is pleased to see an uptick in congressional interest to end the broken payment formula, and plans to use the remaining days of 2014, to advocate for further movement on a permanent solution for fair and stable reimbursement. Since Medicare payments were cut in 2002, Congress has acted on 17 times to stop payment cuts that would have otherwise been required by the SGR.

In a letter to House Republican leadership the GOP Doctors Caucus called for passage of the SGR Repeal and Medicare Provider Payment Modernization Act. Echoing further action to fix the SGR permanently, a group of 114 members of Congress, from both sides of the aisle, implored Speaker John Boehner (R-Oh.) and Minority Leader Nancy Pelosi (D-Calif.) to act, citing the almost record low projected cost to repeal it. All AADA members are urged to contact their Senators and Representatives to take action to reform Medicare’s broken payment system and repeal the SGR formula this year.

Payment reform video pix

Physician Payment Reform:  We Want You for the New Frontier

Recent legislative and regulatory changes provide dermatologists with an unprecedented opportunity to lead changes in care delivery while being rewarded for improving the quality of patient care. The AADA seeks members who are already charting their future. LEARN MORE 

Additional AAD resources

sgr-fix-small.jpg Blueprints for health policy: Efforts in last Congress to pass permanent SGR fix likely to provide framework for future efforts
icon_circle.png 2015 Medicare Physician Fee Schedule
sands  Shifting sands: Changing reimbursement landscape has dermatologists wondering about the future
DAN.png Take action! Contact legislators through the Dermatology Advocacy Network
skinPAC.png Support advocacy efforts through SkinPac