CMS final rule to slash Medicare payments by 27.4%

[CAL/AAEM News Service]

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

November 2, 2011

 

CMS final rule to slash Medicare payments by 27.4% 

 

FierceHealthcare
<http://www.fiercepracticemanagement.com/story/cms-final-rule-slash-medicare
-payments-274/2011-11-02?utm_medium=nl&utm_source=internal> 

 

 

Unless Congress intervenes for an 11th time, physicians will incur a 27.4
percent reduction in Medicare payment rates Jan. 1, according to the Center
for Medicare & Medicaid Services (CMS) final rule released yesterday. While
lower-than-expected Medicare cost growth resulted in a slightly smaller cut
than the 29.5 percent CMS estimated in March, the reduction is nonetheless
massive.

"This payment rate cut would have dire consequences that should not be
allowed to happen," CMS Administrator Dr. Donald M. Berwick said in a press
release. "We need a permanent SGR fix to solve this problem once and for
all."

The American Medical Association (AMA) released a similar statement decrying
the cuts and repeating its call for a solution. "Payments for Medicare
physician services have fallen so far below increases in medical practice
costs that there is a 20 percent gap between Medicare payment updates and
the cost of caring for seniors," AMA President Dr. Peter W. Carmel said. He
continued, "The Joint Select Committee on Deficit Reduction must include
repeal of the formula in their recommendation to Congress to protect access
to care for seniors and stabilize the Medicare program."

Additional payment changes announced in the rule, subject to public comments
until Jan. 31, 2012, include the following:

.         Increases in payments for Medicare beneficiaries' Annual Wellness
Visits to reflect the additional office staff time required to administer a
health risk assessment in conjunction with the visit

 

.         Continuation of CMS's "misvalued code initiative," focusing on
codes billed by physicians in each specialty that result in the highest
Medicare        expenditures under the fee schedule

 

.         Changes to the way CMS adjusts payment for geographic variation in
the cost of practice

 

.         Reduction in payment for a second advanced imaging service
provided by the same physician on the same day

 

.         Expansion of covered telehealth services, including smoking
cessation

 

The final rule will appear in the Federal Register Nov. 28. 

 

 

Marcus Williams &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service

 

 

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