Member Input on the Physician Fee Schedule Proposed Rule

Wednesday, July 25, 2012

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This 60 minute webinar provides an overview of the physician fee schedule (PFS) proposed rule for calendar year 2013. The AHA needs your help to shape our comment letter. Comments are due to the Centers for Medicare and Medicaid Services (CMS) by September 4.

Background:
On July 6, CMS published a proposed rule with changes to the PFS for calendar year 2013. Among other things, the rule proposes to:

• Explicitly pay physicians and non-physician practitioners (NPP) for 30-day post-discharge care coordination and transitional care management services;
• Expand the definition of “group practice” to include groups of 2-24 eligible professionals (EPs);
• Allow certified registered nurse anesthetists (CRNAs) to independently bill for chronic pain management services in accordance with State scope of practice laws;
• Apply a 25 percent multiple procedure payment reduction to the technical component of cardiovascular and ophthalmology diagnostic services;
• Collect data on patient function to improve how Medicare pays for outpatient therapy;
• Implement a new value modifier in 2015 for groups of physicians with 25 or more EPs;
• Modify the physician quality reporting system (PQRS), the electronic prescribing (e-prescribing) program and the voluntary PQRS-Medicare EHR Incentive Pilot; and
• Expand the list of approved Medicare telehealth services.

The rule does not address the issue of the conversion factor under the sustainable growth rate (SGR) formula. Without congressional action, CMS states that physician payments will decline by an estimated 27 percent on January 1, 2013. A detailed AHA Regulatory Advisory on the rule will be available soon on www.aha.org.