Medicare Payment Advisory Commission Recommends Increasing Physician Payments
The Medicare Payment Advisory Commission on Wednesday voted to approve several new recommendations to Congress, including an increase in physician payments and kidney dialysis reimbursements, CQ HealthBeat reports. The recommendations, which will be formalized in a March report to Congress, are summarized below.
- Physician Payments: MedPAC recommended that Congress raise Medicare's physician payment rate by 2.7% in 2006, noting that a "small but consistent share" of beneficiaries have experienced some difficulty in accessing providers.
- Kidney Dialysis: MedPAC also recommended increasing the reimbursement rate for providers of kidney dialysis services by market basket minus 0.4 percentage points, resulting in a net increase of 2.5%.
- Physician Profiling: In addition, MedPAC recommended that Congress monitor physicians' use of tests and procedures -- known as "physician profiling" -- and share the findings with other physicians on a confidential basis to provide comparisons.
- Diagnostic Imaging: MedPAC also recommended that Congress direct the secretary of HHS to establish standards for providers of diagnostic imaging services and physicians who interpret the images. The recommendations would improve Medicare's coding edits to "detect unbundled diagnostic imaging services and reduce Medicare's technical component payment for multiple imaging services performed on contiguous body parts," according to CQ HealthBeat.
- Specialty Hospitals: MedPAC on Thursday recommended that Congress extend the existing moratorium on construction of doctor-owned specialty hospitals until Jan. 1, 2007. The recommendation specifies that Congress could lift the moratorium sooner if Medicare adjusts diagnoses-related payments for severity of illness and recalculates weights in the payments and if Congress gives Medicare the authority to adjust reimbursement for outlier cases and regulate gain-sharing arrangements in which doctors and hospitals would share in savings from more efficient treatments.
- Stark Law: The panel also recommended several changes to the Stark Law, which regulates facilities partially owned by doctors (CQ HealthBeat, 1/13).
On Wednesday, MedPAC recommended that Congress establish a quality incentive payment policy for hospitals, home care facilities and doctors; increase payments to hospitals for both inpatient and outpatient care by market basket minus 0.4 percentage points in 2006 -- resulting in an increase in payments by 2.9%, instead of the full market basket update of 3.3%; and freeze prospective payment rates for home care agencies and skilled nursing facilities in 2006 (California Healthline, 1/13).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.