Instead of a permanent repeal of the unpopular sustainable growth rate (SGR) formula — which was on the table earlier this month — doctors could get a one year delay of Medicare reimbursement cuts.

The latest bill, which Congress is expected to vote on today, would avoid a 24 percent across-the-board cut to provider payments and require the Centers for Medicare and Medicaid Services to produce data used to justify a 25 percent multiple procedure payment reduction, instituted in 2012, to certain imaging procedures provided to the same patient, on the same day, in the same session.

In addition, the bill will include a provision that incentivizes ordering physicians to embrace appropriateness criteria when coordinating medical imaging exams for patients. It would deny payment to those providers who do not follow appropriateness criteria, which are meant to boost quality and cut down on duplicate or unnecessary scanning and their associated costs.

"The imaging appropriateness criteria provisions in this SGR bill will help ensure that patients get the right exam for the right condition and avoid care they may not need. This would raise quality of care and preserve resources without intruding in the doctor-patient relationship or affecting access to care," said Dr. Paul H. Ellenbogen, chair of the American College of Radiology Board of Chancellors.

Also tucked away in the bill is language that would delay the ICD-10 implementation until 2015. This is the new coding system hospitals will use to report medical diagnoses and inpatient procedures. Many hospitals and health systems feel unprepared for the change, but others, including the Advanced Medical Technology Association (AdvaMed), support the transition on Oct. 1.

“We are disappointed that the legislation includes a further delay of the ICD-10 procedure coding system. ICD-10 is the next generation coding system that will modernize and expand the capacity of public and private payers to keep pace with changes in medical practice and health care delivery. New and innovative medical technologies have been living under a code freeze under the limitations of ICD-9. It makes no sense to delay something that will provide higher quality information for measuring service quality, outcomes, safety, and efficiency," said J. C. Scott, senior executive vice president of government affairs at AdvaMed.

The SGR was developed in the 1990s as a way to keep spending on Medicare in line with GDP growth. Medical societies have long lobbied for its repeal. Although they have never gotten it, they have always been granted a reprieve before the cuts have gone into effect.

Many lawmakers were hoping to enact a permanent repeal of the SGR formula and move Medicare toward performance-based payments.

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