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U.S. Senate Approves The Sustainable Growth Rate (SGR) Bill

April 21, 2015

In 1997, Congress passed the Balanced Budget Act, which included a formula for reducing Medicare’s payment rates to healthcare providers over time known as the  Sustainable Growth Rate (SGR).  But out of fear that the SGR’s payment cuts would prevent physicians from agreeing to treat Medicare patients,  Congress delayed its full implementation and passed temporary payment measures instead.  Since 1997, Congress has attempted to find a permanent solution to this issue, and this year, both chambers agreed it was time to repeal the SGR once and for all.  
 
Earlier this year, the House of Representatives passed their version of SGR reform in a bill  that also  retained the Medicare Therapy Cap and Exceptions Process.  The cap limits the amount of outpatient rehabilitation therapy a Medicare beneficiary can receive on an annual basis, but with an ‘exception’ for people with extraordinary needs, such as many people with MS.   Despite concerted efforts among many, many activists and groups to amend the Senate version of the SGR reform with a separate repeal of the Medicare Therapy Cap, the amendment failed by 2 votes.  
 
Last week, the Senate approved their version of the SGR bill by a strong majority, and without an amendment on the rehab therapy cap. The final SGR reform package retains the therapy cap and exceptions process until December 31, 2017, and adds provisions for more targeted reviews of high cost claims.   Most importantly, the SGR bill prevents a 21% reduction in provider payments beginning tomorrow.  Activists will be asked to weigh-in on reforming the rehab therapy caps again when the time is right to approach Congress on it once again. 
 

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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