Commenting on proposed changes in the Medicare Physician Fee Schedule and other Part B payment policies for 2011, the AHA called for a permanent fix of the automatic physician fee cut, disclosure of methodology in the rule's marketbasket update and withdrawal of a payment reduction for therapy services, according to a report by AHA News Now.
The AHA also opposed a proposal to require physician signature on requisitions for clinical diagnostic laboratory tests and urged CMS to require physicians to include hospitals in the written list of imaging suppliers physicians have to provide patients.
Here are some details of CMS' proposed changes, which would go into effect Jan. 1, 2011.
Automatic pay cut raised to 29 percent in 2011. CMS proposes a negative 6.1% update for 2011 under the sustainable growth rate formula, bringing the automatic cut from 21.3 percent this year to 29 percent. This involves a proposed 0.921 “rescaling factor”/ budget neutrality adjustment. In its most recent action on this matter, Congress delayed the pay cut to Dec. 1, 2010.
Reduced payments for imaging equipment. Provisions in the healthcare reform law would reduce Medicare payments for certain diagnostic imaging equipment, including assigning a 75 percent utilization rate assumption to certain expensive diagnostic imaging equipment used in diagnostic CT and MRI services and increases the multiple procedure payment reduction applied to the technical component of certain single session imaging services to contiguous body parts from 25 percent to 50 percent for more than one imaging procedure preformed in the same session. This provision and changes in equipment utilization would save Medicare $160 million next year.
In addition, physicians who refer patients to certain imaging services under the in-office ancillary services exception to the physician self-referral prohibition are required to inform patients that they can receive these services from other area suppliers and to provide a list of alternative suppliers. Physicians are currently not required to include hospital-based imaging services on that list.
Less pay for outpatient therapy services. CMS proposes to establish a multiple procedure payment reduction policy for certain outpatient therapy services reimbursed under Medicare Part B, applying a 50 percent payment reduction to the practice expense component of the second and subsequent therapy services for certain multiple therapy services furnished to a single patient in a single day.
Extend PQRI payments through 2014. CMS proposes to authorize payments under the Physician Quality Reporting Initiative incentive through calendar year 2014. Thereafter, CMS proposes to impose a penalty for physicians who do not provide satisfactory reports or make revisions to the Electronic Prescribing Incentive Program and the Physician Feedback Program.
Read the AHA News Now report on physician fees.
Read other coverage on Medicare physician fees:
- MGMA Report Shows Primary Care Physician Pay Increased in 2009
- Health Law's Controversial Payment Board Holds Promise But May Backfire
The AHA also opposed a proposal to require physician signature on requisitions for clinical diagnostic laboratory tests and urged CMS to require physicians to include hospitals in the written list of imaging suppliers physicians have to provide patients.
Here are some details of CMS' proposed changes, which would go into effect Jan. 1, 2011.
Automatic pay cut raised to 29 percent in 2011. CMS proposes a negative 6.1% update for 2011 under the sustainable growth rate formula, bringing the automatic cut from 21.3 percent this year to 29 percent. This involves a proposed 0.921 “rescaling factor”/ budget neutrality adjustment. In its most recent action on this matter, Congress delayed the pay cut to Dec. 1, 2010.
Reduced payments for imaging equipment. Provisions in the healthcare reform law would reduce Medicare payments for certain diagnostic imaging equipment, including assigning a 75 percent utilization rate assumption to certain expensive diagnostic imaging equipment used in diagnostic CT and MRI services and increases the multiple procedure payment reduction applied to the technical component of certain single session imaging services to contiguous body parts from 25 percent to 50 percent for more than one imaging procedure preformed in the same session. This provision and changes in equipment utilization would save Medicare $160 million next year.
In addition, physicians who refer patients to certain imaging services under the in-office ancillary services exception to the physician self-referral prohibition are required to inform patients that they can receive these services from other area suppliers and to provide a list of alternative suppliers. Physicians are currently not required to include hospital-based imaging services on that list.
Less pay for outpatient therapy services. CMS proposes to establish a multiple procedure payment reduction policy for certain outpatient therapy services reimbursed under Medicare Part B, applying a 50 percent payment reduction to the practice expense component of the second and subsequent therapy services for certain multiple therapy services furnished to a single patient in a single day.
Extend PQRI payments through 2014. CMS proposes to authorize payments under the Physician Quality Reporting Initiative incentive through calendar year 2014. Thereafter, CMS proposes to impose a penalty for physicians who do not provide satisfactory reports or make revisions to the Electronic Prescribing Incentive Program and the Physician Feedback Program.
Read the AHA News Now report on physician fees.
Read other coverage on Medicare physician fees:
- MGMA Report Shows Primary Care Physician Pay Increased in 2009
- Health Law's Controversial Payment Board Holds Promise But May Backfire