2010-07-08
On June 25, 2010, the Centers for Medicare & Medicaid Services (CMS) posted a copy of the proposed Medicare Physician Fee Schedule (MPFS) for 2011. ASH has developed a detailed analysis of the key issues and potential impact on hematology. The proposed rule would implement provisions of the new health-care reform law that expand preventive services for Medicare beneficiaries, improve payments for primary care services, and promote access to health-care services in rural areas. The proposed policies would apply to payments under the MPFS for services furnished on or after January 1, 2011.
The
update in the conversion factor that determines payment for physician fees
remains uncertain
for 2011.
Congress provided a 2.2% increase in payment for June 1 - November
30, 2010. The proposed rule assumes that the current conversion
factor would not be extended, and would result in a 23 percent cut
that would occur on December 1, 2010 plus an additional 6%
reduction in the conversion factor taking effect on January 1,
2011. The rule also proposes to further reduce the
conversion factor by 7.9 percent due to a rebasing of the relative value units
of all physician services.
The proposed rule would continue recent efforts by CMS to implement mandates in the health-care reform law to identify services in categories that are at significant risk for inaccurate payment. It also expands the opportunity to participate in the Physician Quality Reporting Initiative and electronic prescribing. CMS is encouraging participation in these programs with incentive payments. However, incentives will decline and, eventually, penalties will be incurred for inadequate participation.
ASH will submit comments to CMS by the August 24 deadline. If you have any specific concerns or questions, please contact ASH Senior Manager, Policy & Practice, Carol Schwartz at 202-776-0544.
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