Leadership on the House Ways and Means Committee has asked the CMS to take administrative action to avert future cuts to doctors' reimbursement. The Medicare Prescription Drug, Improvement and Modernization Act establishes a 1.5% increase in physician payments in 2004 and in 2005. But starting in 2006 payments are likely to drop 5% annually, according to an April 1 letter to CMS Administrator Mark McClellan from committee Chairman Bill Thomas (R-Calif.) and Rep. Nancy Johnson (R-Conn.), who chairs the panel's health subcommittee. The CMS could revise the formula used to calculate physician payments through administrative actions rather than wait for Congress to pass a bill, Thomas and Johnson said in the letter. Specifically, the CMS should eliminate prescription drug expenditures from the calculations, since physicians don't control growth in drug costs, they said. The formula should reflect the cost of new Medicare benefits, and the CMS should "reexamine its assumptions" about how physicians offset payment deficiencies by increasing the volume and intensity of services, the letter said. A CMS spokeswoman said the agency is reviewing the letter but has not yet responded. -- by Jeff Tieman
Lawmakers ask CMS to change doc pay formula
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