Since the current temporary fix to the SGR (Sustainable Growth Rate) expires at the end of this year, as do the temporary Medicare ambulance increases, congressional leaders reached an agreement last night on a package to extend the SGR fix for three months. The package also includes a three-month extension of the ambulance increases. To help offset the cost of the overall package, negotiators extended the 2% cut under Sequestration to Medicare providers for another year through 2023. There would be a 2.9% cut for the first six months of the year, followed by a 1.11% cut for the remaining six months.

The agreement on a short-term physician fix is being attached to the two-year budget agreement reached today between Senate Budget Committee Chair Patty Murray (D-WA) and House Budget Committee Chair Paul Ryan (R-WI). The two-year budget agreement would fund the federal government and avoid another partial federal government shutdown. The agreement unfortunately would keep the 2% Medicare provider cut in place. The House is scheduled to vote on the two agreements by Friday evening and the Senate sometime before it adjourns next week.

The Medicare Patient Access and Quality Improvement Act (H.R. 2810), which passed the House Ways and Means Committee in July, makes changes to the Medicare physician payment system. Both the House Ways and Means and the Senate Finance Committees have drafted proposals to be considered on December 12, which seek to repeal the current SGR formula for Medicare payments to physicians. The Senate proposal includes a provision to extend for five years the 2% urban, 3% rural and super rural increases to payments under the Medicare ambulance fee schedule. The House proposal does not include any other Medicare provider provisions, but does plan to address them when the SGR repeal package comes to the House floor.