Member Input on the Physician Fee Schedule Proposed Rule

Monday, August 1, 2011

This 60 minute webinar provides an overview of the physician fee schedule (PFS) proposed rule for calendar year 2012 and gathers physician input and reaction. The AHA needs your help to shape our comment letter. Comments are due to the Centers for Medicare & Medicaid Services (CMS) by August 30th.

Background:
On July 19, CMS published a proposed rule with changes to the PFS for calendar year 2012. Among other things, the rule proposes to:

Apply a 50 percent multiple procedure payment reduction to the professional component of advanced imaging services;
Consolidate the two group practice reporting options and define “group practice” as a group with 25 or more eligible professionals;
Make changes to the physician quality reporting system (PQRS) and create a new value-based modifier to adjust physician payments;
Make changes to Medicare electronic health record (EHR) incentive program and create a voluntary PQRS-Medicare EHR Incentive Pilot;
Modify the electronic prescribing (e-prescribing) program, including expanding the definition of a “qualified” system to include one that has certified EHR technology;
Modify the criteria for approving Medicare telehealth services; and
Bundle physician services provided within the three-day inpatient payment window and reimburse for these services at the lower facility rate if they are delivered in a physician’s office wholly owned and operated by the hospital.

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 29.5 percent on January 1, 2012.

A detailed AHA Regulatory Advisory on the rule can be found here

Member Input on the Physician Fee Schedule Proposed Rule

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