On June 25, 2010, the Centers for Medicare & Medicaid Services (CMS) posted a display copy of the proposed Medicare Physician Fee Schedule (MPFS) for 2011. ASH will be developing a complete summary of the proposed rule and analysis of its impact on hematologists as soon as possible. The proposed rule would implement provisions in the new health-care reform law that expand preventive services for Medicare beneficiaries, improve payments for primary care services, and promote access to health-care services in rural areas. The proposed policies would apply to payments under the MPFS for services furnished on or after January 1, 2011.
The proposed rule would also update other policies and payment rates for services by physicians, nonphysician practitioners, and certain other suppliers that are paid under the MPFS during calendar year (CY) 2011. Based on current law, the conversion factor for CY 2011 will be $26.6574. On June 25, the President signed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which replaces the 21.3 percent reduction in physician payment rates that was required by the Sustainable Growth Rate formula for CY 2010 with a 2.2 percent payment increase for services furnished on or after June 1, 2010, through November 30, 2010. Unless action is taken, the 21.3 percent reduction will begin December 1, 2010.
The proposed rule would continue recent efforts by CMS to implement mandates in the health-care reform law to identify services in categories that are at significant risk for inaccurate payment and to further reduce payments in CY 2011 for diagnostic imaging. It would also require physicians referring computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) services under the in-office ancillary services exception to the physician self-referral prohibition, to notify patients that they may receive the same services from other suppliers in the area.
Source:
American Society of Hematology