As ordered reported by the House Committee on Ways and Means on December 12, 2013
H.R. 2810 would replace the Sustainable Growth Rate (SGR) formula, which determines the annual updates to payment rates for physician services in Medicare, with new systems for establishing those payment rates. CBO estimates that enacting H.R. 2810 would increase direct spending by about $121 billion over the 2014-2023 period. (The legislation would not affect federal revenues.) Pay-as-you-go procedures apply to this legislation because it would affect direct spending.
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 ($76 million in 2014, adjusted annually for inflation). The bill contains no private-sector mandates as defined in UMRA.