Yeah, it happened. The SGR is finally dead. Hooray! Sort of. I mean, it's great and all that -- we'll no longer have the annual threat of a massive payment cut from a poorly crafted piece of legislation from the 1990s; we'll no longer have to endure the annual ritual of last-minute legislative theatrics to avert the yearly cuts, we'll no longer have to waste our lobbying time and effort ...

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The 92-8 vote in the United States Senate to join the House in passing the Medicare Access and CHIP Reauthorization Act (MACRA), H.R. 2, represents a remarkable milestone for the Medicare program, and for ACP advocacy on behalf of internists and patients. It is remarkable not only because it eliminates the failed Medicare SGR -- how often does Congress admit it made a mistake, and then correct it? -- but because it ...

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New York officials are doing an “experiment” that should strike fear, anger, and outrage in the hearts of doctors who take care of Medicare patients. (New York has the highest Medicaid budget of any state.) As any doctor who has a high volume of Medicaid patients knows, Medicaid pays practically nothing.  Doctors who take Medicaid usually have to carry a bigger patient load to survive.  Medicaid patients are often sicker than ...

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It has become perhaps the silliest four letters in health care: PQRS. It stands for Physician Quality Reporting System. It’s another this and another that created by the Centers for Medicare & Medicaid Services (CMS). After you read this, you’ll be like me, scratching your head trying to understand why anyone thinks our health care system is better under CMS’s leadership. CMS has setup a thing called PQRS, so physicians across the country ...

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medpagetodayFrom MedPage Today:

  1. Brain Cancer: Did '60 Minutes' Report Raise False Hope? A glioblastoma therapy touted in a "60 Minutes" report that aired Sunday evening, focusing on the use of the polio virus to treat glioblastoma, isn’t a particularly new idea and results are still unpublished -- but some oncologists are worried that patients ...

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As the Affordable Care Act continues to impact millions of Americans through its second year of implementation, many things have become clear to both patients and health care providers alike: nothing is as it seems. While the ACA has provided health care to millions of previously uninsured Americans, it has also robbed many patients of their doctors and has forced others into higher premium, lower service plans.  Even those with ...

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SGR has been the bane of my time in policy.  And I want it to be yours. SGR, formally known as the sustainable growth rate, is a formula developed under none other than the Balanced Budget Act (the same one that set the cap for GME-funded residency slots at 100,000) to determine the Centers for Medicare And Medicaid Services (CMS) reimbursement payments to physicians.  And because the universe loves a good ...

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Members of Congress and the news media have a bad habit of referring to efforts to stop Medicare from arbitrarily cutting payments to physicians for taking care of their patients as the “doc fix.”  Typical is this story from CNN -- “Bipartisan Love: Boehner, Pelosi strike deal to kick doc fix” -- that reported on the release yesterday of an agreement between the two leaders on a bill to repeal ...

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The Centers for Medicare and Medicaid Services (CMS) has put its foot down, this time on the side of patients. Many hospitals charge you more for the same outpatient tests you get in your doctor’s office. Sixty-six different services are being targeted by CMS to leverage the playing field. Are the tests really all that different? We are not talking about inpatient tests that happen when you are sick enough to be ...

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The feds are at it again. Medicare is in the cross hairs with an anticipated 0.9 percent cut to Medicare Advantage plan payments in 2016. The final decision is to be made on April 6 of this year. Medicare Advantage plans are an alternative to traditional Medicare. Traditional Medicare consists of Part A (hospital) and Part B (medical) coverage.  Medicare Advantage plans (Part C) can be chosen in place of the ...

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