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In
this issue
CMS
releases final 2010 Medicare physician fee schedule
The Centers for Medicare & Medicaid Services (CMS) released the 2010
final Medicare physician fee schedule and a related press
release earlier today. The regulation includes provisions that mandated
a 21.2 percent reduction in 2010 Medicare physician payments, unless
Congress enacts legislation to reverse this cut. Without congressional
action before Jan. 1, 2010, the conversion factor will drop to $28.4061.
The anesthesia conversion factor will decrease to $16.6191.
CMS has also made a variety of policy changes that significantly affect
medical group practices. The final rule:
- Eliminates
the use of all consultation codes (inpatient and office/outpatient
codes for various places of service except for telehealth consultation
G-codes) on a budget neutral basis by increasing the work relative
value units (RVUs) for new and established office visits, increasing
the work RVUs for initial hospital and initial nursing facility
visits, and incorporating the increased use of these visits into
practice expense (PE) and malpractice RVU calculations.
- Finalizes
the proposal to remove physician-administered drugs from the
definition of “physician services” for purposes of computing the
physician update formula. This long-awaited administrative step
mitigates the size of future Medicare Part B reductions.
- Phases in
new PE RVUs over four years using revised survey data that will result
in significant increases and decreases to the PE values of many codes.
- Establishes
a Physician Quality Reporting Initiative (PQRI) reporting mechanism
via qualified electronic health records.
- Defines the
size of a group practice as at least 200 providers for purposes of the
new PQRI group-practice reporting option.
- Increases
the utilization assumption for diagnostic equipment priced at more
than $1 million, which will decrease the technical component payment
for services performed on this equipment. This change will be phased
in over 4 years.
MGMA
will analyze the regulation’s impact on medical group practices, post the
analysis online as a member benefit and send formal comments to the agency
detailing any Association concerns. Look for updates in MGMA Washington
Connexion and on the MGMA
Public Policy Web page.
Sign up
now for MGMA's Dec. 3 "Medicare
Update 2010: The Good, the Bad, and the Downright Ugly" Webcast,
and discover how policy and procedural changes made in the Medicare program
for 2010 will affect your reimbursement and practice operations.
FTC
Extends Enforcement Deadline for Identity Theft Red Flags Rule
The
Federal Trade Commission (FTC) is delaying
enforcement of the “Red Flags” Rule until June 1, 2010. As part of
the Federal Trade Commission's (FTC's) implementation of the Fair and
Accurate Credit Transactions (FACT) Act of 2003, most medical providers
would have needed to comply with the "Red Flags" rule November 1,
2009. The rule requires "creditors" – which the FTC defines to
include most health care providers – to establish a program to prevent
identity theft in their practices.
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Oct. 30, 2009
Member Resources
Healthcare Reform Resource Center
Medicare Provider Enrollment Toolkit
Red Flags Rule Resource Center
Recovery Audit Contractors Resource Center
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