Tuesday, July 7, 2009

CMS proposes 21.5% reduction in Medicare payments


Are we going forwards or backwards? CMS is proposing reductions on physician reimbursement for Medicare patients. This may impact over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association (AMA). The Medicare law requires CMS to adjust the MPFS payment rates annually based on an update formula which includes application of the Sustainable Growth Rate or SGR that was adopted in the Balanced Budget Act of 1997. This formula has yielded negative updates every year beginning in CY 2002, although CMS was able to take administrative steps to avert a reduction in CY 2003, and Congress has taken a series of legislative actions to prevent reductions in CYs 2004-2009.

Here's the clencher: "Based on current data, CMS is projecting a rate reduction of -21.5 percent for CY 2010."

So, what do you think about that? Will this drive more physicians to move to a cash-only practice? Concierge medicine? Maybe they will stop accepting Medicare.

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