The U.S. House of Representatives today rejected a Senate bill that would have averted a 27.4 percent Medicare physician payment cut scheduled for Jan. 1 and extended an expiring payroll tax reduction and unemployment insurance benefits. The net result was to leave 2012 Medicare payment rates in limbo.
Continue Reading AMA ALERT-Congress Fails to Avert Medicare Payment Cut
Medicare & Reimbursement
Are ACOs the Answer?
By Michael Cassidy on
Posted in Medicare & Reimbursement
It may seem contradictory that Accountable Care Organizations (ACO) are championed as the new answer to manage more efficiently (i.e. improve quality and reduce costs) when the most popular form of ACOs, i.e. the Medicare Shared Savings Program, established in 2010 as a component of the Patient Protection and Accountable Care Act has yet to…
AMA Reports; Supercommittee Stalemate Leaves SGR 27.5 Physician Fee Schedule Decrease Intact
By Michael Cassidy on
Posted in Medicare & Reimbursement
Supercommittee failure leaves 27 percent Medicare payment cut in place With the Joint Select Committee on Deficit Reduction failing to reach agreement on a deficit-reduction proposal, physicians still face a 27 percent cut in Medicare physician payments scheduled to take effect Jan. 1. Congress has missed an opportunity to address the nation’s fiscal problems, stabilize…
CMS Releases 2012 Medicare Physician Fee Schedule With 27.4% Decrease
By Michael Cassidy on
Posted in Medicare & Reimbursement
CMS ANNOUNCES POLICY, PAYMENT RATE CHANGES FOR THE PHYSICIAN FEE SCHEDULE IN 2012
The Centers for Medicare & Medicaid Services (CMS) today issued a final rule with comment period that updates payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY)
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https://www.medlawblog.com/2011/11/articles/medicare-reimbursement/845/
By Michael Cassidy on
Posted in Medicare & Reimbursement
HHS has issued its 2012 OIG Work Plan. Following are some particular areas of concern for physicians:
Physician-Owned Distributors of Spinal Implants: OIG will determine the extent to which physician-owned distributors (PODs) provide spinal implants purchased by hospitals and whether PODs are associated with high use of spinal implants. The Work Plan notes that Congress has…
Final CMS Accountable Care Organization Regulations Provide ACOs more Flexibility
By Michael Cassidy on
Posted in Medicare & Reimbursement
CMS has finally released the final rule for the Medicare Shared Savings Program, which is the program that establishes the rules for Accountable Care Organizations (ACOs).
The initial industry objections to the ACO concept and the proposed regulations was that it was so complicated, so limited and potentially so expensive that it would be impossible…
CMS Streamlines ASC Patient Notice Rule
By Michael Cassidy on
Posted in Medicare & Reimbursement
CMS has taken a small step to implement President Obama’s executive order instructing federal agencies to eliminate regulations that obsolete or overly burdensome to business.
On October 24, 2011 CMS published the final rule revising Ambulatory Surgery Center (ASC) conditions for coverage to allow patient rights information to be provided to the patient, the patient’s…
Obamacare CLASS Program Abandoned
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Obama administration has halted plans to implement the long-term care program in the 2010 health care law after determining that financing plans for it were not sufficient.
The Community Living Assistance Services and Supports (CLASS) Act, a program championed by the late Sen. Edward M. Kennedy, has come under withering criticism from…
U.S. Physician Practices Spend Four Times As Much As Payer Administrative Money As Canadian Counterparts
By Michael Cassidy on
Posted in Medicare & Reimbursement
A commonwealth fund supported studies reported some key findings:
1. Physician practices in the United States spent $82,975.00 per physician per year interacting with payers compared with $22,205.00 in Canada.
· If U.S. physicians had similar administrative costs to their Canadian counterparts, the total annual savings would be $27.6 billion dollars.
· U.S.
2011 Medicare Physician Guide
By Michael Cassidy on
Posted in Medicare & Reimbursement
CMS has published a revised Medicare Physician’s Guide.
http://www.cms.gov/MLNProducts/downloads/MedicarePhysicianGuide_ICN005933.pdf