President Obama Signs the Pathway for SGR Reform Act of 2013
–New Law Includes Physician Update Fix through March 2014–
On December 26, 2013, President Obama signed into law the Pathway for SGR Reform Act of 2013. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients…
The AMA Wire reports the following action on the Medicare Physician Fee Schedule:
*3-month Medicare payment update approved for Jan. 1
*Congress has adopted a 0.5 percent update to Medicare payments for three months, following a bipartisan vote of 64 to 36 in the U.S. Senate Wednesday afternoon.
*The president is expected to sign…
I recently posted the SGR White Paper published jointly by the Senate Finance Committee and the House Ways and Means Committee. Earlier this week, both committees endorsed legislation enacting those concepts.
The section by section summary of the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 is attached. Unfortunately, both the House and…
The House Ways and Means Committee and the Senate Finance Committee have jointly issued a White Paper proposing the repeal of the Medicare Sustainable Growth Rate Formula, entitled “SGR Repeal and Medicare Physician Payment Reform”.
The SGR white paper acknowledges that the Sustainable Growth Rate formula is “fundamentally broken” and that application…
Highmark Launches Accountable Care Alliance
Attached is the press release;
https://www.highmark.com/hmk2/newsroom/pressreleases/2013/pr071813.shtml
More to come when the details are evaluaited.
CMS has issued the poroposed Medicare Physician Fee Schedule. Without Congressional intervention, the SGR will mandate a 24.4% decrease. CMS sent its calcuations to the Medare Payment Advisory Commission.
CMS has also issued a Fact Sheet Summary:
Additional Time to Establish Protocols for Newly Required Face-to-Face Encounters for DME
Due to concerns that some providers and suppliers may need additional time to establish operational protocols necessary to comply with face-to-face encounter requirements mandated by the Affordable Care Act (ACA) for certain items of Durable Medical Equipment (DME), CMS will start actively enforcing…
The Society of General Internal Medicine convened the National Commission on Payment Reform to formulate a recommendation for healthcare payment reform. This Commission released its Report in March 2013. Although we have attached the report, here are the 12 fundamental recommendations.
1. Over time, payers should largely eliminate stand-alone fee-for-service payment to medical practices because of …
The American Taxpayer Relief Act of 2012 includes the Physician Update Fix, which essentially provides a 0% Medicare change for 2013. The Centers for Medicare & Medicaid Services (CMS) is currently revising the 2013 Medicare Physician Fee Schedule (MPFS) to reflect the new law’s requirements as well as technical corrections identified since publication of the final…
OIG Advisory Opinion No. 12-15 has approved an existing arrangement under which a hospital pays physicians a per diem fee for providing on call ER coverage.
Under the arrangement, the hospital pays per diem fees to 130 specialty physicians on staff who provide on-call services, including:
· telephone consultations;
· in-person consultations, as…
