Thursday, July 28, 2011

Proposed Rule 2012: 29.5 Percent Cut in Physician Payment Rates Likely

With physician pay cut looming large, right now you need to have a lasting (Sustainable Growth Rate) SGR fix to do away with this problem for good.

If the 2012 Medicare payment rates proposed in the Centers for Medicare & Medicaid fee schedule becomes final, physician practices could be taking yet another hit. Physician practices can expect a 29.5 percent payment cut for covered services, According to CMS' July 1 release.

According to the release, total projects under the Medicare Physician Fee Schedule (MPFS) in CY 2012 will be to the tune of $80 billion.

A brief background: The release further informs that the proposed rule threatens to bring down payment rates based on the SGR formula. But then the cuts have been avoided every time except in the year 2002. In fact, last year, it took three different legislations to prevent the cuts, informs the release.

Consequences: Said Dr. Donald M. Berwick, CMS Administrator in the release, "This payment cut would have serious consequences and we cannot and will not allow it to happen."

In the proposed rule, the agency is significantly expanding the potentially misvalued code initiative, the release notes.

Strong efforts are required to assess Medicare's fee schedule to see to it that it's paying right and ensuring that Medicare beneficiaries remain to have access to vital services like primary care services, the release cites.

Among other changes, the agency is also proposing to expand its multiple procedure payment reduction to the professional interpretation of advance imaging services.

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