The Blue Cross Association posted some reactions from organized medicine to the recent agrement by the AMA to develop performance measures. See http://bcbshealthissues.com.

The American Medical Association has signed pact with Congress “agreeing” as follows:

*The parties will develop a total of 140 quality measures covering 34 clinical areas.

*Doctors will voluntarily report on at least 3 to 5 quality measures per physician by 2007.

*Doctors should receive additional reimbursement to cover administrative costs.
Continue Reading AMA AND CONGRESS SIGN P4P AGREEMENT

DEFICIT REDUCTION ACT OF 2005:
SUMMARY OF MEDICARE REIMBURSEMENT CHANGES

President Bush signed the Deficit Reduction Act of 2005 (DRA 2005) on February 8, 2006. DRA 2005 contained numerous budget cutting provisions impacting Medicare and Medicaid reimbursement programs. Following is a description of the most significant.
Continue Reading DEFICIT REDUCTION ACT OF 2005:

AMBULATORY SURGERY CENTER, GAIN SHARING DEMONSTRATION PROJECTS, THERAPY SERVICE, AND SPECIALTY HOSPITAL REFERRAL PROHIBITIONS

As reported last week, the House of Representatives has passed the Deficit Reduction Act of 2005 (DRA 2005), which is expected to be signed by President Bush in the very near future. When ultimately passed, we will provide a more detailed explanation of the critical issues, but the following are additional reimbursement issues impacted by DRA 2005:
Continue Reading MORE DRA 2005 REIMBURSEMENT NEWS

Physicians had hoped for budget neutrality in the Deficit Reduction Act of 2005, i.e., the “zero update,” expecting the 4.4% decrease implemented by the current Medicare Sustainable Growth Rate rules to be eliminated. The general reimbursement reduction mandated for 2006 was eliminated by DRA 2005, but DRA 2005 requires that the cost of the physician reimbursement increases be offset by future reductions, meaning that DRA 2005 is simply postponing these reimbursement decreases until future years.
Continue Reading Deficit Reduction Act — U.S. House Of Representatives Approves But Medicare Physician Increases Limited

On December 23, 2005, CMS implemented a streamlined PVRP by reducing the number of quality indicators to be reported using G-Code indicators from the original 36 to a “core set” of 16 special quality indicators. The revision was described in a new MedLearn Matters Release (MM 4183) and was implemented as of January 3, 2006.
Continue Reading CMS Revises Physician Voluntary Reporting Program (PVRP)

AUTOMATIC 4.4% MEDICARE REDUCTION EFFECTIVE JANUARY 1, 2006; CMS ADVISES DELAYED SUBMISSION TO EXPEDITE PLANNED “ZERO UPDATE”

CMS officials suggested that physicians intentionally delay submitting claims to await passage of the “zero update” feature of the proposed Deficit Reduction Act of 2005.
Continue Reading AUTOMATIC 4.4% MEDICARE REDUCTION EFFECTIVE JANUARY 1, 2006

The centers for Medicaid and Medicaid Services (CMS) reported today that quality of care has improved significantly in hospitals participating in the premier hospital quality incentive demonstration project, a groundbreaking Medicare pay for performance demonstration project. The press release was posted on the CMS website on
November 14, 2005.

See CMS Press Release.