SGR Repeal and Medicare Provider Payment Modernization Act of 2015

1/11/2023, 1:28 PM

SGR Repeal and Medicare Provider Payment Modernization Act of 2015

Amends title XVIII (Medicare) of the Social Security Act (SSAct) to: (1) remove sustainable growth rate (SGR) methodology from the determination of annual conversion factors in the formula for payment for physicians' services, and (2) revise the update in rates for 2015 and subsequent years.

Directs the Secretary of Health and Human Services to establish a Merit-based Incentive Payment (MIP) system under which eligible professionals (including physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists) shall receive annual payment increases or decreases based on their performance.

Requires specified incentive payments to eligible participants in an alternative payment model.

Requires the Secretary to: (1) draft a plan for development of quality measures to assess professionals, including non-patient-facing professionals; and (2) make payments for chronic care management services.

Expands the kinds of uses of Medicare data available to qualified entities. Directs the Secretary to provide Medicare data to qualified clinical data registries to facilitate quality improvement or patient safety.

Declares it a national objective to achieve widespread exchange of health information through interoperable certified electronic health records technology nationwide by December 31, 2018.

Congress
114

Number
HR - 1470

Introduced on
2015-03-19

# Amendments
0

Sponsors
+5

Cosponsors
+5

Variations and Revisions

3/19/2015

Status of Legislation

Bill Introduced
Introduced to House
House to Vote
Introduced to Senate
Senate to Vote

Purpose and Summary

SGR Repeal and Medicare Provider Payment Modernization Act of 2015

Amends title XVIII (Medicare) of the Social Security Act (SSAct) to: (1) remove sustainable growth rate (SGR) methodology from the determination of annual conversion factors in the formula for payment for physicians' services, and (2) revise the update in rates for 2015 and subsequent years.

Directs the Secretary of Health and Human Services to establish a Merit-based Incentive Payment (MIP) system under which eligible professionals (including physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists) shall receive annual payment increases or decreases based on their performance.

Requires specified incentive payments to eligible participants in an alternative payment model.

Requires the Secretary to: (1) draft a plan for development of quality measures to assess professionals, including non-patient-facing professionals; and (2) make payments for chronic care management services.

Expands the kinds of uses of Medicare data available to qualified entities. Directs the Secretary to provide Medicare data to qualified clinical data registries to facilitate quality improvement or patient safety.

Declares it a national objective to achieve widespread exchange of health information through interoperable certified electronic health records technology nationwide by December 31, 2018.

Alternative Names
Official Title as IntroducedTo amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals, and for other purposes.

Policy Areas
Health

Potential Impact
Advisory bodies•
Child health•
Congressional oversight•
Fraud offenses and financial crimes•
Government information and archives•
Government studies and investigations•
Health care costs and insurance•
Health care coverage and access•
Health care quality•
Health information and medical records•
Health personnel•
Health promotion and preventive care•
Health technology, devices, supplies•
Medicaid•
Medical research•
Medicare•
Minority health•
Performance measurement•
Poverty and welfare assistance•
Right of privacy•
Rural conditions and development•
User charges and fees

Comments

Recent Activity

Latest Summary4/21/2015

SGR Repeal and Medicare Provider Payment Modernization Act of 2015

Amends title XVIII (Medicare) of the Social Security Act (SSAct) to: (1) remove sustainable growth rate (SGR) methodology from the determination of annual conversion...


Latest Action3/31/2015
Referred to the Subcommittee on the Constitution and Civil Justice.