SGR Overhaul’s Impact on Texas EMS

Congress’ recent passage of H.R. 2, which will eliminate the Medicare physician payment reimbursement program – sustainable growth rate (SGR) – and replace it with a completely new way to reimburse physicians, will have an impact on all segments of the health care system, including Texas EMS.

TEMSA’s April 6 membership newsletter examined some of the provisions in H.R. 2, which included:

  • A 33-month extension of the Medicare ambulance add-on payments.
  • The rates include the 2-percent rural, 3-percent rural and super rural bonus.  “Sec. 203. Extension of ambulance add-ons. Extends the add-on payment for ground ambulance services, including in super-rural areas until January 1, 2018.”

The Centers for Medicare and Medicaid Services (CMS) included an explanation of how the temporary payment increases for ambulances may have come to an end without Congressional action.  Click here for details.

In the future, physicians who would like to have Medicare payment increases will have to choose between a quality-based incentive model or a model in which the physician has up to 50 percent of his or her patients in a new type of payment model (ACO, bundled payment, medical home, etc.).

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