As ordered reported by the House Committee on Energy and Commerce on July 31, 2013
H.R. 2810 would replace the Sustainable Growth Rate (SGR) formula, which determines the annual updates to Medicare’s payment rates for physician services, with new systems for establishing those payment rates. CBO estimates that enacting H.R. 2810 would increase direct spending by about $175 billion over the 2014–2023 period. Pay-as-you-go procedures apply to this legislation because it would affect direct spending. (The legislation would not affect federal revenues.)
H.R. 2810 would impose an intergovernmental mandate as defined in the Unfunded Mandates Reform Act (UMRA) by preempting state laws governing the evidentiary rules and practices of medical malpractice claims. CBO estimates that the costs of the intergovernmental mandate would be small and would not exceed the threshold established in UMRA ($75 million in 2013, adjusted annually for inflation). The bill contains no private-sector mandates as defined in UMRA.