The Centers for Medicare & Medicaid Services has issued a final rule that will implement key provisions in the Affordable Care Act to expand preventive services for Medicare beneficiaries.
At the same time, the rule calls for a 29.4 percent pay cut to Medicare physicians by Jan. 1.
According to CMS officials, the rule will also improve payments for primary care services and promote access to healthcare services in rural areas. They will apply to payments under the Medicare Physician Fee Schedule for services furnished on or after Jan. 1, 2011.
The final rule will appear in the Nov. 29, 2010 Federal Register, and CMS will accept comments on certain aspects until Jan. 2, 2011.
CMS Administrator Donald Berwick, MD, called the rule "a major step" toward improving the health status of Medicare beneficiaries by providing coverage for annual wellness visits. The rule will also eliminate out-of-pocket costs for most preventive services beginning Jan. 1, 2011, reducing barriers to access for many beneficiaries, he said.
The rule also implements an Affordable Care Act provision to improve access to primary care services by providing a 10 percent incentive payment for primary care services furnished by primary care practitioners, Berwick said.
According to the rule, the primary care incentive payment is available for family physicians, general internists, geriatricians, pediatricians, nurse practitioners, clinical nurse specialists and physician assistants for whom primary care services represent 60 percent or more of their MPFS allowed charges in a prior period.
CMS officials said they made adjustments to proposed policies in response to public comment so that more primary care physicians and non-physician practitioners can qualify for the incentive payments.
The final rule also implements an ACA provision to provide a 10 percent incentive payment to general surgeons performing major surgery in areas designated by the federal government as health professional shortage areas (HPSAs). It also allows physician assistants to order post-hospital extended care services.
Read the rule here.