This is going to Hurt

July 20th, 2009 | Sources: Wall Street Journal

Subjects: ,

The Centers for Medicare and Medicaid Services announced last Wednesday that it was changing its payment rates to providers in 2010.

cmsThe new rates will increase payouts to beleaguered primary care practitioners while snubbing radiologists and cardiologists, among others.

Among the perks for PCPs, CMS has proposed a bump in payments for the Initial Preventive Physical Exam, a.k.a. the “Welcome to Medicare” visit to reflect the true complexity of the service.

CMS also proposed to change the way Medicare recognizes professional liability expenses such that Medicare’s support for these costs is redirected to providers experiencing the highest malpractice premiums.

isthatamisprintBeyond that, the news was gloomier than Boston’s weather this June. 

CMS is, for example, proposing to remove physician-administered drugs from the definition of “physician services” and to stop paying for consultation codes, which are typically billed by specialists at a rate higher than procedurally similar evaluation and management (E/M) services. 

Overall, the changes would increase payments to GPs, family physicians, internists, and geriatric specialists by 6-8%, according to a CMS press release. The biggest losers will be radiologists, especially interventional radiologists who should see cuts of at least 20% for most imaging tests.

Payments to cardiologists would be cut about 11% overall, with cuts of up to 42% for reading an echocardiogram and 24% for performing cardiac catheterization.

Cuts “like this threaten the successes we have had over the years with reducing heart disease,” ACC president Alfred Bove warned the Wall Street Journal.

Meanwhile Ted Epperly, president of the American Academy of Family Physicians, said the CMS proposal would drive more medical students into primary care, and hailed the pay raise for his constituency as “long overdue.”


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