Current
Fee Schedule/Medicare Payment Update
An October 30, 2003 announcement by the Centers for Medicare
and Medicaid Services (CMS) reported that the CY 2004 update
to Medicare physician payments will be negative 4.5 percent
unless Congress passes physician payment relief legislation
to adjust the update. The House and Senate Medicare bill conferees
have reportedly tentatively agreed to provisions that would
avert the 4.5 percent cut in CY 2004. More >>
Regulatory Activity
- AAMC submitted a comment letter on the Center for Medicare
and Medicaid Services' (CMS) proposed rule regarding Revision
to Payment Policies Under the Physician Fee Schedule for
Calendar Year 2003. CMS will publish a final rule on or
around November 1, which will become effective on January
1, 2003. The proposed rule addresses one issue with the
physician fee schedule, which has received attention during
the past year. Specifically, CMS changed its approach to
calculating the Medicare Economic Index (MEI) and the 2003
MEI update is calculated at 3.0%; CMS' previous treatment
of the MEI would have resulted in an MEI update of 2.3%.
Under the Proposed Rule this change in the MEI results in
a proposed Conversion Factor (CF) change of -4.4% instead
of -5.1%.
- Issues with the Physician Fee Schedule methodology and
calculations continue to exist. AAMC, AMA and 22 other physician
societies recently sent a letter to Administrator Scully
regarding CMS' inclusion of the cost of drugs in the Sustainable
Growth Rate target (SGR), the methodology used to calculate
spending targets for services paid under the physician fee
schedule. Inclusion of the costs of these drugs is a key
contributor to the payment cuts that CMS predicts in the
next decade. CMS is urged to use its acknowledged authority
to remove the costs of drugs from the SGR target and thus
help to address one issue with the payment system.
Payment for Professional Services of Certain Nonphysician
Practitioners
The final rule implements BBA provisions, effective January
1, 1998, for payment of the services of nonphysician providers
defined as, nurse practitioners, clinical nurse specialists,
certified nurse-midwives, and physician assistants. More >>
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