For years, Congress has temporarily bypassed the SGR so physicians wouldn’t have to endure double-digit reimbursement reductions. However, policymakers face growing pressure to repeal and replace the flawed payment formula, giving physicians permanent relief from looming pay cuts.
Here are five key things to know about the SGR and the push to eliminate it once and for all.
1. The Balanced Budget Act of 1997 amended the Social Security Act to create the SGR formula, which was meant to control growth in Medicare spending for physicians’ services, according to CMS. The formula takes into account the estimated percentage change in fees for physicians’ services, the estimated percentage change in expenditures due to changes in laws or regulations, the change in the average number of Medicare fee-for-service beneficiaries and the estimated 10-year average annual percentage change in real gross domestic product per capita.
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