Senate Passes Health Reform Bill

December 23, 2009


Updated on December 28, 2009

The US Senate passed the Patient Protection and Affordable Care Act (H.R. 3590) on December 24, 2009. The process to reconcile the House and Senate versions will begin after the New Year.

Unfortunately, a permanent fix to the Medicare sustainable growth rate (SGR), as well as an amendment that would add neurology to the list of providers eligible for a primary care bonus, were not included in the final version of the Senate legislation. The Academy will continue to strongly advocate for neurology's inclusion as a specialty eligible for the primary care bonus during the reconciliation process of the Senate and House reform bills. In addition, the Academy will continue to push for separate legislation to permanently replace the flawed Medicare SGR formula.

On December 21, the Senate adopted a "managers amendment" that, according to the American Medical Association (AMA), contained items important to physicians, including:

  • A change to make cost of the 10-percent payment bonus for primary care and general surgery not offset by cuts in other physician services
  • Elimination of the proposed enrollment fee for physicians who participate in Medicare and Medicaid
  • Elimination of the proposed one year 0.5 percent patch to SGR, which, according the AMA, makes funds available to offset the costs of these changes, and keeps open the possibility of a permanent repeal of SGR to happen next year. A provision in the recently passed Department of Defense appropriations bill averts the January 1, 2010, cut of 21 percent by extending the 2009 conversion factor for an additional 60 days.

View an updated comparison chart of the respective House and Senate health reform bills.

Stay tuned to for further updates.

For more information, contact Mike Amery at