Docs urge Congress to fend off an­other round of Medi­care cuts

Modern Healthcare - - Contents - Melanie Evans

The Amer­i­can Med­i­cal As­so­ci­a­tion called for Congress to stall an up­com­ing Medi­care pay cut to doc­tors for more than a year, af­ter a CMS rule on the cut was re­leased last week.

The AMA urged Congress to post­pone a sched­uled cut to Medi­care physi­cian pay, which the CMS an­nounced last week would re­duce re­im­burse­ment to doc­tors by 24.9% as of Jan. 1 un­der the sus­tain­able growthrate for­mula. Medi­care is sched­uled to re­duce doc­tor re­im­burse­ment by 23% as of Dec. 1 and an­other 1.9% one month later, ab­sent a move by Congress.

“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,” said AMA Pres­i­dent Ce­cil Wil­son in a writ­ten state­ment.

The CMS noted in its fi­nal pay­ment rule that Congress has author­ity—and has used it each year since 2003—to over­ride the cuts and de­scribed a long-term so­lu­tion as crit­i­cal. “We are com­mit­ted to per­ma­nently re­form­ing the Medi­care pay­ment for­mula,” the CMS said.

The agency last week also pub­lished fi­nal rules for home-health agen­cies, which will see pay­ments re­duced by 4.89% in 2011, and out­pa­tient hos­pi­tal and am­bu­la­to­ry­surgery cen­ters. The home-care pay­ment cuts will amount to $960 mil­lion in 2011, the agency said.

The Am­bu­la­tory Surgery Cen­ter As­so­ci­a­tion said it was pleased that the fi­nal rule in­creases ASC pay­ments by 0.2%, as op­posed to a freeze in rates pro­posed ear­lier.

Fi­nal rules for out­pa­tient hos­pi­tal and am­bu­la­tory-surgery cen­ters in­cluded some changes called for un­der the Pa­tient Pro­tec­tion and Af­ford­able Care Act, in­clud­ing a ban on new or ex­panded physi­cian-owned hos­pi­tals and ef­forts to re­dis­tribute un­used med­i­cal res­i­dency slots among med­i­cal schools.

The out­pa­tient hos­pi­tal and surgery cen­ter rule also in­creases the qual­ity mea­sures that must be re­ported in 2012, 2013 and 2014 to re­ceive full pay­ment. The agency said it would in­crease to 15 from 11 the num­ber of mea­sures re­ported in 2012 and add an­other eight in 2013 but said no new mea­sures would be adopted in 2014.

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