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HR 574 113th Congress House Health Congressional oversight Government information and archives Government studies and investigations Health personnel Medicare

Medicare Physician Payment Innovation Act of 2013

Introduced: February 6, 2013 See on congress.gov
 Everywhere this bill has been 4 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Feb 14, 2013
Referred to the Subcommittee on Health.
Feb 8, 2013
Referred to the Subcommittee on Health.
Feb 6, 2013
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Feb 6, 2013
Introduced in House
 Plain-English summary Congressional Research Service

Medicare Physician Payment Innovation Act of 2013 - 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 2014 update to the single conversion factor in such formula.

Establishes updates for separate primary care and other service categories beginning January 1, 2015, as well as separate conversion factors and separate updates through 2018 for each service category.

Directs the Secretary, through the Center for Medicare and Medicaid Innovation, to: (1) expand testing of each innovative 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.

Specifies as such a model, subject to testing, payment for outpatient therapy services and speech language pathology services on the basis of a treatment session, an episode of care, or other bundled payment methodology as a model to be tested during 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.

Freezes the physician fee schedule for 2019 by requiring 0.0 updates to the relevant conversion factors.

Directs the Secretary to: (1) contract and agree with regional extension centers to provide guidance and assistance on how physicians may transition to implementation of alternative health care delivery models identified as represernting best practices; and (2) make certain funding available to the Office of the National Coordinator for Health Care Technology to award grants and incentive payments under a competitive process to regional extension centers and other qualified entities for such activities.

Requires the Office to: (1) establish a process for the competitive selection of regional extension centers (and other qualified entities) in the third quarter of 2015, and (2) authorize the initial distribution of funds to such centers and entities.

Prescribes updates to conversion factors for 2020-2023, but freezes them again beginning in 2024.

Requires the Secretary to consider certain factors in determining the growth rates to be recognized beginning with 2020 for alternative payment and delivery models.

Directs the Secretary to report to Congress on the impact on spending and on access to services under Medicare resulting from changes to the Medicare delivery and payments systems, including those made by this Act.

What's happening now February 14, 2013

Referred to the Subcommittee on Health.

 Committees of jurisdiction 4