The Medicare physician payment fee for 2012 is not as bad as predicted, but the lesser cut will be cold comfort to physicians. The Centers for Medicare & Medicaid Services (CMS) released its final rule for the physician fee schedule for 2012 yesterday. The cut in Medicare payments based on the sustainable growth rate (SGR) formula sets the payment reduction at 27.4 percent rather than the anticipated 29.5 percent.
In a statement about the final rule and the payment cut, CMS noted that Congress has bypassed the cuts 10 out of 11 times and that the Obama administration is committed to fixing the SGR.
"This payment rate cut would have dire consequences that should not be allowed to happen," said Donald Berwick, MD, CMS administrator, in the statement. "We need a permanent SGR fix to solve this problem once and for all. That's why the President's Budget and his Plan for Economic Growth and Deficit Reduction call for permanent, fiscally responsible reform and why we are committed to working with the Congress to achieve a permanent and sustainable fix."
Calling the country's doctors "the backbone of our healthcare system," CMS Secretary Kathleen Sebelius reiterated Berwick's remarks in a statement of her own released yesterday.
"We have not and will not let deep cuts to doctors' payments occur," she said in her statement. "The Obama administration is 100 percent committed to fixing the flawed Medicare payment system and protecting Medicare beneficiaries' access to doctors."
Doctors and medical associations across the country have been lobbying Congress to fix the SGR. They have warned that such severe cuts could mean that physicians will have to close their practices and/or stop taking Medicare patients.
Several solutions to the SGR problem have been offered by various stakeholders, but nothing yet has been set into motion. If no solution is put in place or if Congress does not bypass the 27.4 percent cut, the payment reduction is scheduled to take effect on Jan. 1.
[See also: MedPAC approves SGR repeal proposal.]
Other changes set forth in CMS' final rule include adjustments to payments based on geographic variation in cost of practice; expansion of the multiple procedure payment reduction policy to the professional interpretation of advance imaging services; the adoption of criteria for a health risk assessment to be used with Annual Wellness Visits; inclusion of smoking cessation services in the list of services available through telehealth; modifications to incentive programs such as the Physician Quality Reporting System, the ePrescribing Incentive Program and the Electronic Health Records Incentive Program.
The final rule will be published in the Federal Register on Nov. 28. Comments will be accepted through Jan. 3.
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