AMA Analyzes Medicare Physician Fee Rule

The American Medical Association has prepared an eight-page analysis of the government's proposed 2014 Medicare Physician Fee Schedule.

The Centers for Medicare & Medicaid Services (CMS) proposal does not address the overall impact of the Sustainable Growth Rate (SGR) formula on physician fees. CMS will release that information in November. Previously, CMS estimated the SGR will reduce payments to physicians by 24.4 percent effective Jan. 1 if Congress takes no action before then.

The AMA analysis covers the 605-page rule's provisions on relative value units, payments for care coordination, the Medicare Economic Index, geographic practice cost indexes, Physician Compare, the Physician Quality Reporting System, electronic health record incentives, value-based payment modifiers, physician feedback reports, telehealth services, billing by chiropractors, colorectal cancer screening, clinical laboratory fees, and liability for overpayments. It also breaks down total allowable charges by specialties.

Efforts in Congress to repeal the SGR continue. In July, the House Energy and Commerce Committee passed and sent to the full House of Representatives HR 2810, the Medicare Patient Access and Quality Improvement Act of 2013. It has received bipartisan support. Instead of just delaying the inevitable annual pay cut, as Congress has done for more than a decade, the bill creates a two-phase plan to eliminate the SGR and provide five years of stable fee updates. It then transitions to a new quality reporting system that links physician pay to a set of physician-endorsed quality measures, while allowing doctors to opt into alternative payment models.

Neither AMA nor the Texas Medical Association fully endorsed the legislation, but leaders of both organizations say they are pleased to see a constructive SGR replacement bill actually gaining some traction in Congress.

The September issue of Texas Medicine will have more information on the bill. 

Action, Aug. 16, 2013