Medicare Physician Payment Innovation Act of 2012
Latest action (9 May 2012): Introduced
What this bill does
This bill, the Medicare Physician Payment Innovation Act of 2012, proposes to change how Medicare pays doctors. It would eliminate the current system for determining physician fees, known as the sustainable growth rate, starting in 2013. Instead, for 2013, physician payment updates would be frozen at 0%. Starting in 2014, separate payment rates and updates would be established for primary care services and all other physician services, with different update percentages through 2017.
The bill also directs the Secretary of Health and Human Services to test and evaluate new ways of delivering and paying for healthcare in at least three geographic regions. These evaluations would include the cost for physicians to implement new models. The Comptroller General would study these evaluations, and the Secretary would publicly list models that reduce spending without harming care quality, or improve care quality without increasing spending.
Additionally, the bill would provide guidance and funding to help physicians transition to these new models, with a goal of widespread implementation by January 1, 2017. Physician fee schedules would be frozen again in 2018. The bill also outlines updates for physician payments from 2019 through 2022, with further freezes starting in 2023, but includes exemptions for providers using alternative models. This bill was introduced in the House of Representatives in May 2012 and is currently in the "Introduced" status.
Plain-English summary generated by Bill100 AI from the official record. Always verify against the source below.
Official summary
Medicare Physician Payment Innovation Act of 2012 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to revise requirements for payments for physician's services to eliminate the sustainable growth rate system from the formula for determination of the fee schedules for such services.
Sets at 0.0 the 2013 update to the single conversion factor in such formula.
Includes the program of Osteopathic Continuous Certification of the American Osteopathic Association as a Maintenance of Certification Program with respect to any plan of the Secretary of Health and Human Services (HHS) to integrate reporting on quality measures with reporting requirements relating to the meaningful use of electronic health records (EHR).
Establishes updates for separate primary care and other service categories beginning January 1, 2014, as well as separate conversion factors and separate updates through 2017 for each service category.
Directs the Secretary, through the Center for Medicare and Medicaid Innovation, to: (1) expand testing of each payment and service delivery model in at least three geographic regions; and (2) include analysis of average implementation costs, per physician, in evaluations of models in phase 1 testing.
Directs the Comptroller General to study the evaluations of each model tested.
Directs the Secretary to release to the public a comprehensive list of such health care delivery models identified as likely to: (1) reduce spending without reducing quality of care, or (2) improve the quality of patient care without increasing spending.
Requires the Secretary to inform physicians, nurse practitioners, group practices, and institutions employing Medicare part B (Supplementary Medical Insurance) providers on how best to transition to alternative health care delivery and payment models aimed at improving the coordination, quality, and efficiency of health care.
Common questions
- What does H.R. 5707 do?
- This bill, the Medicare Physician Payment Innovation Act of 2012, proposes to change how Medicare pays doctors. It would eliminate the current system for determining physician fees, known as the sustainable growth rate, starting in 2013. Instead, for 2013, physician payment updates would be frozen at 0%. Starting in 2014, separate payment rates and updates would be established for primary care services and all other physician services, with different update percentages through 2017. The bill also directs the Secretary of Health and Human Services to test and evaluate new ways of delivering and paying for healthcare in at least three geographic regions. These evaluations would include the cost for physicians to implement new models. The Comptroller General would study these evaluations, and the Secretary would publicly list models that reduce spending without harming care quality, or improve care quality without increasing spending. Additionally, the bill would provide guidance and funding to help physicians transition to these new models, with a goal of widespread implementation by January 1, 2017. Physician fee schedules would be frozen again in 2018. The bill also outlines updates for physician payments from 2019 through 2022, with further freezes starting in 2023, but includes exemptions for providers using alternative models. This bill was introduced in the House of Representatives in May 2012 and is currently in the "Introduced" status.
- Has H.R. 5707 become law?
- Not yet. As of 9 May 2012, H.R. 5707 is introduced.
- Who sponsored H.R. 5707?
- H.R. 5707 was sponsored by Rep. Allyson Schwartz [D-PA13, 2005-2014] (Democrat-PA), with 28 cosponsors.
- What's the latest action on H.R. 5707?
- Introduced (9 May 2012).
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