Senate Finance Committee Reports Out Bipartisan Fix to Medicare Physician Payment with Several Amendments Championed by Sen. Carper

WASHINGTON- Today, Sen. Tom Carper (D-Del.), a member of the Senate Finance Committee and Chairman of the Senate Committee on Homeland Security and Governmental Affairs, voted to report out of the Senate Finance Committee Medicare physician payment legislation, including the repeal and replacement of the Sustainable Growth Rate (SGR).

“Today we took a positive step forward by reporting out a bill to permanently repeal and replace the current Medicare fee-for-service system,” Sen. Carper said. “This bicameral and bipartisan bill will help improve health outcomes and drive down costs by encouraging our country’s health care providers to participate in accountable care organizations, patient-centered medical homes and other innovative payment and delivery models. Instead of paying physicians and other health care providers for the number of services they provide, this legislation encourages our country’s health care providers to keep patients as healthy as possible.  With the cost of repealing the SGR at a historic low, we cannot afford to continue to kick the can down the road on reforming Medicare physician payments. Today we took an important step towards improving and stabilizing Medicare payments to physicians, and I am hopeful that we will be able to enact this bicameral and bipartisan solution.”

In addition to reporting out the SGR fix, the Senate Finance Committee approved a number of provisions to enhance the Medicare program, several of which Sen. Carper introduced or co-sponsored. They include:

Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME)

Among its provisions, the PRIME Act would: enact stronger penalties for Medicare and Medicaid fraud; curb improper or mistaken payments made by Medicare and Medicaid; establish stronger fraud and waste prevention strategies within Medicare and Medicaid to help phase out the practice of “pay and chase;” take steps to help states identify and prevent Medicaid overpayments; and improve the sharing of fraud data across state and federal agencies and programs.

Waiver Authority for Programs of All Inclusive Care for the Elderly (PACE) to participate in Centers for Medicare and Medicaid Innovation Center programs.

The amendment allows PACE to participate in demonstration programs under Section 1115 Research & Demonstration Projects and the Center for Medicare and Medicaid Innovation (CMMI).  This amendment would allow the CMMI to test and improve the PACE program’s ability to reduce hospitalizations and emergency room use, manage chronic illness, and improve functioning and quality of life; and also encourages the Centers for Medicare and Medicaid Services to increase operational flexibility and reduce administrative barriers that hinder PACE enrollment.

Quality Measurement to Encourage Health Care Providers’ Transfer of Existing Patient Care Preferences

Under current law, hospitals, nursing homes, and home health agencies frequently fail to transfer existing patient health care information and preferences when patients are discharged from the hospital or move into a new care setting.  As a result, patients may receive inadequate or inappropriate services that do not follow the patients’ own preferences and decisions. The amendment would create a Medicare quality measure based on the transfer of patient health information and care preferences as they move to other care settings or return home.

An amendment to allow physician assistants to provide and manage hospice care for Medicare beneficiaries

This amendment seeks to amend the Social Security Act to allow physician assistants to provide and manage hospice care services for Medicare beneficiaries.