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New Payment Rules Will Benefit Primary Care MDs – Drug Benefits Proposed to Move to Medicare Part D

Posted Jul 04 2009 9:42pm

For Oncologists, this stands to represent a big help in the chemotherapy area as the cost of maintaining the expensive drugs has been a rising cost over the last few years.  The proposed changes are not due until the year 2010.  Radiologists will be looking at a 30% reduction with the proposed adjustment and cardiologist around an 11% cut with left heart catheterizations, transthoracic echocardiograms, and EKG payments being reduced.  I just posted about a hand held ECG device and perhaps devices as such might be having an impact too on the compensation. image

Hand Held Electrocardiogram (ECG) Device – Add 2 Drops to the Device and Send the Information to the Cardiologist or Physician (No paper required)

AMA Now Says Government Funded Insurance Would be OK – CMS Proposes 21.5% Medicare Physician Pay Cut

"Welcome to Medicare" visits are something new that is added for a higher reimbursement for primary care physicians as well as changes to the consultation fees and codes with "evaluation and management" being selected that pays at a lesser rate which may result in lesser pay for specialists.  CMS is accepting comments on the new rules until the end of August and the final ruling is expected by November 1st.  BD

WASHINGTON, July 2 -- The Centers for Medicare and Medicaid Services (CMS) has announced proposed changes that will increase Medicare payments for primary care physicians by an estimated 6% to 8%.

Changes include refining the definition of practice expenses, eliminating payment for consultation codes, and revising treatment of malpractice premiums, as well as adjustments to the physician fee schedule (PFS), according to a CMS press release.

One of the biggest changes would remove physician-administered drugs, such as chemotherapy agents, from the "physician services" category used under the sustainable growth rate (SGR) formula.

Doctors have long lobbied CMS to put the drugs under Medicare's Part D drug benefit, rather than keeping them in Part B, the section of Medicare that determines how much physicians are paid.

CMS has finally agreed.

CMS will accept comment on the new rules until Aug. 31 and will issue a final rule by Nov. 1. The new payment rules will apply to physician services provided after Jan. 1, 2010.

Medical News: CMS Announces New Payment Rules that Benefit Primary Care Docs - in Public Health & Policy, Medicare from MedPage Today

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