United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-10-19 U.S. Government Printing Office 2004-10-08 monographic deposited born digital 78 p. GA 1.13:GAO-05-85 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-05-85 P0b002ee180b23426 f:d0585 DGPO 2010-10-19 2011-03-24 GAOREPORTS-GAO-05-85 machine generated eng fdlp REPORT GAOREPORTS-GAO-05-85 GAO-05-85 Medicare Physician Payments Other Written Product A13032 Concerns were raised about the current system Medicare uses to determine annual changes to physician fees--the sustainable growth rate (SGR) system--when fees were reduced by 5.4 percent in 2002. Subsequent administrative and legislative actions modified or overrode the SGR system, resulting in fee increases for 2003, 2004, and 2005. However, projected fee reductions for 2006-2012 have raised new concerns about the SGR system. Policymakers are considering whether to eliminate spending targets or modify them. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required that GAO study SGR and potential alternatives to the system. This report examines (1) how the SGR system is designed to control spending for physician services, (2) what concerns have been raised about the SGR system and its components, (3) what affects the stability and predictability of physician fee updates under the SGR system, and (4) what alternatives to the current SGR system exist. GAO reviewed relevant laws and regulations and interviewed officials and organizations representing physicians. On the basis of this information, GAO identified potential alternatives to the SGR system and requested illustrative simulations of fee updates and spending on physician services from the Centers for Medicare & Medicaid Services (CMS). https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-05-85/html/GAOREPORTS-GAO-05-85.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-05-85/pdf/GAOREPORTS-GAO-05-85.pdf GAO-05-85 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-05-85 Other Written Product GAO-05-85; Medicare Physician Payments: Concerns about Spending Target System Prompt Interest in Considering Reforms; Medicare Physician Payments Volume 100 Page 82 100 Stat. 82 Volume 103 Page 2106 103 Stat. 2106 Volume 111 Page 251 Volume 111 Page 350-355 Volume 111 Page 435-39 111 Stat. 251 111 Stat. 350-355 111 Stat. 435-39 Volume 113 Page 348-49 Volume 113 Page 1501A Volume 113 Page 1501A-321 113 Stat. 348-49 113 Stat. 1501A 113 Stat. 1501A-321 Volume 117 Page 11 Volume 117 Page 2066 Volume 117 Page 2233-2255 Volume 117 Page 2300 Volume 117 Page 2301 117 Stat. 11 117 Stat. 2066 117 Stat. 2233-2255 117 Stat. 2300 117 Stat. 2301 Public Law 99-272 Public Law 101-239 Public Law 105-33 Public Law 106-113 Public Law 108-7 Public Law 108-173