CMS Proposes Additional 6.1% Physician Payment Cut Beginning in 2011
A proposed rule from CMS includes a provision that could impose an additional 6.1% reduction to Medicare's physician reimbursement rates beginning in 2011, HealthLeaders Media reports (Simmons, HealthLeaders Media, 6/28).
Physicians recently faced a 21.3% cut to Medicare reimbursement rates, but a bill (HR 3962) signed by President Obama on Friday delays that cut through November. The measure, which is fully offset with two revenue-raising provisions, also provides a 2.2% Medicare payment increase to physicians through November (California Healthline, 6/28).
Unless Congress alters the sustainable growth rate formula or acts to avert the cuts, physicians essentially would face a 23.5% reduction in Medicare payments beginning in December. According to HealthLeaders Media, the 6.1% reduction would be in addition to those scheduled reductions.
The proposed rule, which includes provisions related to the implementation of health reform, is open to comment until Aug. 24. CMS is expected to issue a final rule by Nov. 1. The proposed rule also would:
- Eliminate out-of-pocket costs for preventive services for Medicare beneficiaries by waiving the Medicare Part B deductible and 20% coinsurance normally applied to such services beginning in 2011;
- Define elements of care that must be included in a consultation for it to be classified as a wellness visit;
- Define primary care services and outline incentive payments to primary care providers;
- Offer incentives for physicians who perform major surgical procedures in areas with few health professionals;
- Allow physician assistants to order post-hospital extended care services for beneficiaries;
- Require physicians whose offices perform certain imaging services to provide patients with a list of other facilities that offer the same services; and
- Increase review of misvalued codes under the physician fee schedule (HealthLeaders Media, 6/28).