Obama signs three-month SGR fix into law

A new law that temporarily stops Medicare payment cuts also extends additional provisions that benefit optometrists.

On Dec. 26, President Obama signed into law a bipartisan budget agreement that included a 0.5 percent increase to Medicare physician payments from Jan. 1 through March 31. Physicians were facing a 24 percent cut to reimbursement in 2014 if Congress hadn't intervened.

"Optometry is very hopeful and optimistic that an SGR fix bill will be passed by Congress and signed by the president."

This huge cut "would have been financially devastating to optometric offices," said Roger Jordan, O.D., chair of the AOA Federal Relations Committee. The temporary fix gives offices enough time to plan financially, with the knowledge that there is a set three-month period before the cut is put back in place, he noted.

The law also extends an existing 1.0 floor on the geographic practice cost index through March 31. This index is one method Medicare uses to adjust payment for certain medical procedures based on the practice costs of a specific area.

According to Rodney Peele, AOA's assistant director for regulatory policy and outreach, the 1.0 floor prevents Medicare from paying less than the national average for services in lower-cost states. It should continue to help many in the optometry field.

"This is a continued big win for mostly the rural offices," Dr. Jordan said.

In addition, the law extends the exceptions process for outpatient therapy caps. The extension means optometrists who file for these services "will continue to treat their patients as they have [in the past] and will continue filing and be reimbursed without any changes in the process," Dr. Jordan said.

AOA pushes for a permanent fix

The temporary measure buys Congress more time to seek a permanent solution to Medicare's sustainable growth rate formula, which has threatened automatic payments to Medicare doctors for more than a decade. Bills in the House and Senate seek to freeze or marginally increase payments over the next five years. They also would replace the SGR formula with a value-based reimbursement system.

Buoyed by grassroots AOA efforts, the Senate bill specifically includes ODs as eligible participants in a new quality-improvement program.

"Optometry is very hopeful and optimistic that an SGR fix bill will be passed by Congress and signed by the president" in 2014, Dr. Jordan said.

December 30, 2013

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