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The chart below, edited for the blog, appears in the proposed 2011 Medicare Physician Fee Schedule. It illustrates the need for a permanent Medicare payment fix, showing the impact of the sustainable growth rate (SGR) on physician payments over the next six months.

The picture looks bad with payments for high volume services dropping between 2% and 12%, but it's even worse considering the 2010 payments are about 23% less than what is paid today. For example, 99203 (Office/outpatient visit, new) currently pays $99.93, but it's set to pay $76.93 on Dec. 1 and $72.67 on Jan. 1.

Part B News subscribers can see current 2010 Medicare payments along side the December 2010 and January 2011 payments.

Read more on Medicare payments

Dr. Donald Berwick (photo by: Richard Chase, used with permission from Harvard University)The White House is using the recess appointment process to seat Harvard health policy professor and former pediatrician Donald Berwick MD at the helm of CMS. The move by the Obama administration avoids Senate confirmation hearings and any further delay of Dr. Berwick overseeing the agency running the Medicare program.

Republicans are unhappy that they are losing the chance to question Dr. Berwick on his positions regarding public run health care and previous statements he has made about rationing health care. Sen. John Barrasso MD, an orthopedic surgeon, (R-Wyo.) states:

"This recess appointment is an insult to the American people. Dr. Berwick is a self professed supporter of rationing health care and he won't even have to explain his views to the American people in a Congressional hearing. Once again, President Obama has made a mockery of his pledge to be accountable and transparent."

Click here to read more on the next CMS administrator

HealthCare.gov screenshotThe Obama administration recently launched HealthCare.gov to promote new programs and insurance reforms in the Affordable Care Act (ACA), commonly known as the health reform law.

The site provides a breakdown of the law and gives physicians, patients and insurers a practical understanding of the reforms. After that - I couldn't find much utility for physician practices. I clicked on the "Health Care Providers" link to get the "new resources and support" that the ACA promises to provide, but the site offered only short summaries of the law. The landing page for providers was a dead end. Overall, the information was nice to have, but the info won't directly help a practice today.

For example, under "Talking to Your Patients About Health Reform" section of the providers page it mentions the annual wellness exam and preventative care without copays starting in 2011. Again, there's just a summary of the provision, there is not enough detail or explanation to help practices get ready for the initiatives or explain the new coverage to patients.

You've got the usual 60 days to comment on all the provisions in CMS's proposed 2011 Medicare Physician Fee Schedule (PFS). Just visit www.regulations.gov or click our direct link to the comment page for the proposed rule. The official deadline to file your comment is 11:59 p.m., Eastern Time, on Aug. 24.

Part B News subscribers can download a special supplement to our proposed 2011 Medicare Physician Fee Schedule coverage in the latest edition of the newsletter. We've compiled seven charts impacting physician reimbursements into one document. The charts are:

  • CPT codes subject to 90% equipment utilization rate assumption that will be subject to 75% assumption in 2011;
  • Codes proposed to be added to the 75% equipment utilization rate assumption list;
  • Separately payable "Always Therapy" Services subject to the proposed MPPR policy;
  • Proposed Cost Share Weights for GPCI update;
  • Primary care services eligible for primary care incentive payments in 2011;
  • Total allowed charge estimated impact for RVU, MPPR, and MEI rebasing changes; and,
  • Impact of proposed rule and estimated physician update on payment for selected codes.

The document is labeled "2011_Proposed_MPFS_charts.pdf" in the Hot Documents section of the PBN Library.

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