CMS releases final 2011 OPPS rules -and- Doctor Payment Rates Cut Again Under New Medicare Rules

CAL/AAEM News Service calaaem.news.service at gmail.com
Fri Nov 5 19:27:44 PDT 2010


CAL/AAEM: California Chapter of the American Academy of Emergency
Medicine

November 2, 2010

CMS releases final 2011 OPPS, ASC, PFS, HH rules

 

AHA
<http://www.ahanews.com/ahanews_app/jsp/display.jsp?dcrpath=AHANEWS/AH
ANewsNowArticle/data/ann_110210_rules&domain=AHANEWS>  News Now

 

The Centers for Medicare & Medicaid Services late today issued final
rules updating Medicare payment policies and rates for hospital
outpatient departments, ambulatory surgical centers, physicians and
home health agencies for calendar year 2011. In the final outpatient
prospective payment system/ASC rule, responding to comments from
hospitals, CMS says it will seek input from an advisory committee to
review and recommend changes to the level of supervision for
outpatient therapeutic services. Because establishing this process
will require CMS to issue a separate proposed rule, the agency says it
will extend the moratorium on enforcement for Critical Access
Hospitals for another year and extend it to other rural hospitals with
fewer than 100 beds. CMS also finalizes its proposal for a set of 16
services requiring direct supervision by a physician or non-physician
practitioner to begin the service (referred to as "initiation),
followed by "general" supervision for the remainder of the service.
The services include observation, intravenous infusion, and
therapeutic, prophylactic or diagnostic injection. Other outpatient
therapeutic services will continue to require direct supervision
throughout the entire procedure. CMS also released rules finalizing
rates for the physician fee schedule andhome health PPS. The AHA is
reviewing the final rules and will provide members with additional
details in a Special Bulletin tomorrow.

 

See this link for the full release:
http://www.ofr.gov/OFRUpload/OFRData/2010-27969_PI.pdf

 

 

November 3, 2010

Doctor Payment Rates Cut Again Under New Medicare Rules

 

Kaiser
<http://www.kaiserhealthnews.org/Daily-Reports/2010/November/03/Medica
re-Payment.aspx>  Health News

 

The Center for Medicare and Medicaid Services posted final Medicare
payment rules Tuesday that include a cut in physician reimbursement
rates. 

 

"Physicians are once again staring down the barrel of a two-digit cut
in Medicare reimbursement -- pay will go down by 21% on Dec. 1, and
another 4% cut will be loped off on Jan. 1, according to a final
payment rule issued" by CMS, MedPage Today reports. "The American
Medical Association wasted no time in condemning the cut, and issued a
call to arms to mobilize the nation's physicians to press Congress to
pass legislation this month to avert it. 'Physicians are anxious about
the future, and [are] making decisions now about how many Medicare
patients they can see and their participation status in Medicare for
next year,' AMA President Cecil Wilson said in a statement. 'Congress
needs to send a strong message that seniors and physicians can count
on Medicare by stopping the cut for at least 13 months, providing time
for Congress to fix the Medicare mess once and for all'" (Frieden,
11/2).

 

CQ HealthBeat: "Final rules were also issued for the home health
prospective payment system rate update for calendar year 2011, as well
as changes in certification requirements for home health agencies and
hospices. Proposed cuts in payments put in place by the rule had
already raised deep concern among providers. CMS said that updates
were issued for national standardized 60-day episode rates, national
per-visit rates, non-routine medical supply conversion factors and the
low utilization payment adjustment (LUPA) add-on payment amounts. All
are effective under the Medicare prospective payment system effective
Jan. 1" (Reichard and Norman, 11/2).  

 

 

Anna Parks &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine

 

 

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