Bill would delay implementation of pay-for-performance reporting program

September 1, 2007

A group of medical specialty organizations, including AUA, is pushing new legislation that would delay permanent implementation of Medicare's "pay for performance" quality reporting program to allow for a more orderly transition to the new system of Medicare reimbursement.

Sponsored by Senators Benjamin L. Cardin (D-MD) and Arlen Specter (R-PA), the Voluntary Medicare Quality Reporting Act of 2007 was introduced in late May on behalf of the Alliance of Specialty Medicine, of which AUA is a member. The Alliance represents more than 200,000 physicians nationwide.

Introduced in the House of Representatives by Bart Gordon (D-TN) and John Shadegg (R-AZ) in mid-June, the legislation would amend the provision in the Tax Relief and Health Care Act of 2006 that requires the Centers for Medicare & Medicaid Services to develop a new quality reporting program for 2008, even before a 6-month trial of the 2007 Physician Quality Reporting Initiative (PQRI) is completed.

In introducing the bill, Cardin pointed out that the PQRI program was established last year when Congress prevented a scheduled across-the-board cut of 5.1% in Medicare physician reimbursement rates and froze payment levels. Under PQRI, providers became eligible for a one-time bonus payment of 1.5% of total allowed Medicare charges if they reported certain quality measures starting in July 2007.

"Everyone wants the best possible care for Medicare beneficiaries," Cardin said, "but I am very concerned about moving forward with standards that have not been adequately tested. We must have the right process in place for defining quality measures, and a good system needs sufficient time to assess its appropriateness and effectiveness."

Key components of the bil include: