195.033 Medicare Payment Incentives and Penalties


Medicare Payment Incentives and Penalties: The Texas Medical Association advocates that any Medicare penalty or incentive program including the Value-Based Payment Modifier program and the Merit-Based Incentive Payment System be designed so that: (1) the measures and standards used do not result in financial penalties for physicians when their patients do not comply with orders or recommendations for testing and treatment; (2) physicians are not penalized for providing services to disadvantaged patients; (3) physicians are not penalized for noncompliance with obsolete or superseded guidelines and standards; and (4) both cost and quality measures are adequately risk adjusted to eliminate the effects of poverty, poor educational attainment, and cultural differences from the measures used to adjust payment. Until all of the above are implemented, Medicare payments should not be adjusted using these measures (CSE Rep. 2-A-12; amended CSE Rep. 6-A-17).

Last Updated On

May 31, 2017