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Sustainable growth rate may spur significant reduction in Medicare physician payments in 2012
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A proposed Medicare Physician Fee Schedule calls for a 29.5% reduction in physician payments in 2012, according to a news release from the Centers for Medicare and Medicaid Services.
CMS issued the proposed ruling on the fee schedule July 1. The payment cut would take effect Jan. 1, 2012, unless Congress intervenes.
Current law requires CMS to base annual fee schedule updates on the sustainable growth rate (SGR). However, CMS is looking to Congress to alter or eliminate the SGR, Donald M. Berwick, MD, CMS administrator, said in the release.
“This payment cut would have serious consequences and we cannot and will not allow it to happen,” Dr. Berwick said. “We need a permanent SGR fix to solve this problem once and for all. That’s why the President’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix.”
Michael X. Repka, MD, American Academy of Ophthalmology medical director for governmental affairs, echoed Dr. Berwick’s statement.
“Congress cannot allow the SGR to reduce payments to physicians. They must fix this problem so that fair payments to physicians are maintained,” Dr. Repka said in an email interview with Ocular Surgery News. “Continuing uncertainty in the physician fee schedule makes it difficult for ophthalmologists to plan for the future.”
The ruling proposes quality and cost measures to be used in designating a new value-based modifier that would reward physicians for improving care quality and efficiency. The Affordable Care Act requires CMS to adjust payments to some physicians by Jan. 1, 2015, and all physicians by Jan. 1, 2017.
CMS will accept comment on the proposed ruling until Aug. 30. A final ruling is scheduled to be issued Nov. 1.