June 2006 Practice Update

Medicare Proposes Significant Revisions for Physician Reimbursement
Medicare released the proposed rule on the Five-Year Review and Practice Expense on June 21, 2006. The rule includes the largest revisions to evaluation and management (E/M) services ever proposed. Proposed changes to physician work would increase expenditures by approximately $4.0 billion. ASH was active in the lengthy Five-Year Review process and will thoroughly review comments on the proposed changes. New methodologies for calculating practice expense are proposed for both direct and indirect costs, and, if the proposed changes are implemented, the non-physician work pool will be eliminated. Visit the ASH Web site for more details on the proposed changes, or the Medicare Web site to download the proposed rule. Additional information on the Medicare 2007 Physician Fee Schedule will be available upon the release of the proposed changes.

Development of Hematology Quality Metrics Continues
Progress continues on the development of hematology-specific quality metrics. Quality metrics will have an important role in upcoming Medicare program models. ASH continues work with the AMA Physician Consortium and Medicare on the metrics, which are now available for review on the ASH Web site. We strongly encourage you to review them and share comments with us.

ASH Prepares to Launch New Performance Improvement Module (PIM)
In early July, the online ASH PIM for myelodysplasia will go live. This is the first of three PIMs which will cover both malignant and benign hematology. After completing the ASH PIM, the American Board of Internal Medicine (ABIM) will award you 20 points towards Maintenance of Certification and 20 CME credits.

Medicare Releases Third Quarter Pricing for Part B Drugs
Medicare posted on its website the pricing files for Part B drugs starting July 1. Most drugs get minor increases. IVIG is an exception, with an 11.9 percent increase for lyophilized form and a 3.5 percent increase for liquid form. Please review the files for changes regarding the Part B drugs for your practice.

Medicare Payment Advisory Commission (MedPAC) Releases Report
MedPAC released its report to Congress, titled Increasing the Value of Medicare, on June 15, 2006. The MedPAC report examines increasing accountability and care coordination for the Medicare program. The report also discusses physician resource use, practice expense rates, and findings related to Part D.

Competitive Acquisition Program Physician Enrollment Period Extended
Medicare extended the physician election period for the Competitive Acquisition Program (CAP) through June 30, 2006. Physicians who choose to participate must return their completed election forms to their local carrier by mail.

Please submit comments on any of the items above to ASH Practice Advocacy Manager Pamela Ferraro.