And speaking of MedPAC, each year the Commission releases a June report advising Congress on issues affecting the Medicare program including broader changes in health care delivery and the market for health care services. The latest June report focuses on making the Medicare program more consistent by reforming Medicare payment models, risk adjustment payments, primary care service payments, and select condition payments.
Medical Billing Blog
On April 30th, the House Committee on Ways and Means Subcommittee on Health held a hearing to solicit input from the HHS Inspector General’s office (OIG), CMS and the Government Accountability Office (GAO) on ways to improve Medicare oversight and reduce waste, fraud and abuse. Gloria Jarmon, Deputy Inspector General for Audit Services, Office of Inspector General, testified on behalf of HHS; Shantanu Agrawal, M.D., Deputy Administrator and Director, Center for Program Integrity, testified on behalf of CMS; and Kathy King, Director, Health Care testified on behalf of GAO.
Yesterday, by a voice vote, the House of Representatives passed legislation postponing the 24% physician fee schedule cut slated to take effect on April 1, 2014. However, the legislation went well beyond just temporarily fixing the SGR problem, it also made a number of other changes that will have long-lasting implications. A listing of those changes is at the end of this message.
On January 17th, CMS announced a new policy regarding Freedom of Information Act (FOIA) requests for the disclosure of how much Medicare pays individual physicians. For the past 30 years, this information has been protected from FOIA requests under the Personal Privacy Exemption (Exemption 6) of the act. Under the new policy,CMS will begin examining each FOIA request on a case-by-case basis to determine if the information requested should be exempt from FOIA requests.
Centers for Medicare and Medicaid Services (CMS) released its 2014 Medicare physician fee schedule (PFS) Final Rule. CMS calculates the 2014 Physician Fee Schedule Conversion Factor (CF) to be $27.2006, or a 20.1% reduction from the current CF of $34.0230. Total payments under the fee schedule in 2014 are projected to be at $87 billion, according to CMS. Payments to physicians are calculated primarily on three key factors: the resource-based relative value scale (RBRVS), the geographic practice cost indexes (GPCIs), and the monetary conversion factor (CF).