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Specialty Physicians Express Concerns over Proposed Changes to Medicare Physician Fee Schedule

08/27/2010

The Alliance expressed concerns to Dr. Donald Berwick, Administrator of the Centers for Medicare and Medicaid Services (CMS), in a letter released this week, over proposed changes to the Medicare Physician Fee Schedule (MPFS) for 2011. Specifically, the group expressed fears that some of the provisions, as written, will force many physicians to reduce access to Medicare patients. The group also provided a number of recommendations to CMS for consideration.

In the letter, the Alliance addressed a number of concerns over proposed changes to the MPFS. This includes, among others, concerns that that the proposed 10-year moving average window could result in a multifactor productivity adjustment (MFP) for ambulatory surgical centers (ASC) that is different from the MFP adjustment for providers paid on a fiscal year basis and that this difference could become yet another factor that causes further divergence in ASC and hospital outpatient department payment rates. The Alliance requested that CMS develop one MFP adjustment for providers for which the 10-year moving average window would not vary by calendar or fiscal year.

The Alliance also responded to CMS’ request for public comment on physician perspectives on CY 2010 coding and payment methodologies. Citing numerous examples of the cost-cutting steps physicians have taken to offset revenue losses associated with the elimination of these codes, the group respectfully requested that CMS closely examine the negative impact the elimination of the reporting of all CPT consultation codes is having on the coordination of care for Medicare beneficiaries and provide confirmation that this change was conducted in a budget neutral manner, as initially proposed.


To view the letter, click here.

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