Physicians will face a slightly smaller but still massive cut in their Medicare payment rates under a revised schedule the administration issued Tuesday for the fees it plans to pay starting in 2012.
An across-the-board Medicare payment reduction of 27.4% is expected, according to the new fee schedule, which is slightly less than the 29.5% cut the administration had previously anticipated. The cuts are mandated under the program's cost-control funding formula established by the Balanced Budget Act of 1997.
Congress is considering a variety of proposals to again delay payment cuts, as it has repeatedly voted to do in recent years.
HHS Secretary Kathleen Sebelius in a written statement called for repeal of the payment formula, but the Obama administration has not offered a specific replacement or a way to pay for that change.
The AMA issued a statement repeating its previous calls for the deficit reduction supercommittee to add the cost of the payment formula's repeal to their final legislative package, which is expected by Thanksgiving.
Another announced change will implement the third year of a four-year transition to new practice expense relative value units. Separately, the CMS proposed changes to several physician incentive programs, including the physician quality reporting system, the e-prescribing incentive program and the electronic health-records incentive program.
Additional payment changes announced Tuesday include small increases in payments for the annual wellness visits of Medicare beneficiaries; changed values for 300 physician fee-schedule service codes deemed “misvalued”; and adjustments to the system used to tweak Medicare payments to account for varying local practice costs.
Another change would reduce some imaging payments by up to 50% for repeated scans within the same visit.
The CMS also added smoking and tobacco cessation counseling, among other services, to the list of telehealth services for which Medicare will reimburse providers.
Additionally, for certain physician-provided pharmaceuticals CMS will lower reimbursements to 103% of the average manufacturer's price from 106% of the manufacturer's average sales price.
