CMS PROPOSES PAYMENT, POLICY CHANGES FOR PHYSICIANS SERVICES TO MEDICARE BENEFICIARIES IN 2010
The Centers for Medicare & Medicaid Services (CMS) announced today proposed changes to policies and payment rates for services to be furnished during calendar year (CY 2010) by over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). The MPFS sets payment rates for more than 7,000 types of services in physician offices, hospitals, and other settings.
CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services. The proposals include an update to the practice expense component of physician fees. For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association.
The Medicare law requires CMS to adjust the MPFS payment rates annually based on an update formula which includes application of the Sustainable Growth Rate or SGR that was adopted in the Balanced Budget Act of 1997. This formula has yielded negative updates every year beginning in CY 2002, although CMS was able to take administrative steps to avert a reduction in CY 2003, and Congress has taken a series of legislative actions to prevent reductions in CYs 2004-2009. Based on current data, CMS is projecting a rate reduction of -21.5 percent for CY 2010.
As part of health care reform, the Administration supports comprehensive, but fiscally responsible, reforms to the physician payment formula. Consistent with this goal, the Administration announced in the FY 2010 President’s Budget that it would explore the breadth of options available under current authority to facilitate such reforms, including an assessment of whether the cost of physician-administered drugs should continue to be included in the payment formula. Thus, while working with Congress to develop a more appropriate mechanism for updating physician payment rates, CMS is proposing to remove physician-administered drugs from the definition of “physician services” for purposes of computing the physician update formula in anticipation of enactment of legislation to provide fundamental reforms to Medicare physician payments. While the proposal will not change the projected update for services during CY 2010, CMS projects that it would reduce the number of years in which physicians are projected to experience a negative update.
CMS is also proposing to stop making payment for consultation codes, which are typically billed by specialists and are paid at a higher rate than equivalent evaluation and management (E/M) services. Practitioners will use existing E/M service codes when providing these services instead. Resulting savings would be redistributed to increase payments for the existing E/M services.
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9 comments:
I have 3 questions? If this Healthcare bill is so great and better than what we have now how come our seniors can not be provided for? Illegals are getting better health care and is this right? If this health care bill is so great how come Obama stated he will not give up his present health insurance and sign up for his Healthcare his bill offers if passed? The same goes for several Politians.
Take a look at Massachuttes health care and tell me how its working.
why do liberals always end up hurting the people they're trying to help?
That's a simple one. Because they're stupid.
They are dreamers who bank on the best. You should hope for the best, but prepare for the worst.
Why do they keep cutting medicare and not touching medicaid. People that are on medicare have paid into the system for years. Most of the ones on medicaid have paid next to nothing. We keep paying for illegals to have kids yet we dont take care of our own. Does anyone else find this absurd?
The idea of rates being cut any more for physicians and ancillary providers is not good at all. All private insurance companies base their rates off of Medicare, so if this cut goes through all private insurance rates will decrease as well. This is a time to reach out to you senators and representatives and ask them to vote again this bill. Providers can't live off of nothing. As far as Medicaid, most providers try not to accept it because the rates are a joke!
if physician reimbursement drops 21% you will see a mass-exodus of providers in this country as it will not pay to provide medical services.
I second 2:08-we need to cut corners on Medicaid.Just like all other types of public assistance,make them prove they either cannot work or find a job.When able-bodied people are getting free medical care its sickening to those of us who pay.Enough is enough!
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