Sixty members of Congress urged the CMS to drop plans for a proposed cut in physician payments when similar clinical activities are performed at the same facility on the same day. The expansion of multiple-procedure payment reductions and a 25% cut in the technical component for “potentially redundant direct practice expense inputs” was proposed earlier this year, and a final rule is expected in November. “We find the expansion of the MPPR included in the proposed rule is inappropriate and creates disincentives for specialists to provide high-quality, patient-centered care,” the representatives wrote in a letter to acting CMS Administrator Marilyn Tavenner.

The first version of the payment cut for potentially redundant services, which was proposed last year as a cost-saver by the Medicare Payment Advisory Commission, was directed at radiology and will take effect Jan. 1. The expansion of the cut the letter focused on would apply to ophthalmology, vascular surgery and cardiology. Physicians' advocates are worried the CMS will continue to expand the cut through all medical specialties as a way to achieve more cost savings. The letter reiterated a long-standing physician criticism: that the cut targets actions that are not redundant but required by different physicians in different parts of a practice or hospital for individual reasons aimed at providing comprehensive care for their patients.