CMS final rule to cut 2011 Medicare pay for physicians

POSTED IN: Reimbursement, Policy and Legislation

The Centers for Medicare & Medicaid Services has issued a final rule that calls for a 24.9 percent pay cut for physicians beginning Jan. 1.

"While Congress has provided temporary relief from these reductions every year since 2003, a long-term solution is critical," said Donald Berwick, CMS administrator.

"Broad physician participation in Medicare is essential to ensuring that beneficiaries continue to have access to care, and physician engagement is critical to our efforts to strengthen the quality of care," Berwick said. "Medicare needs to be a strong, dependable partner with physicians – and that means the SGR must be fixed. The administration supports permanently reforming the Medicare payment formula."

According to CMS officials, the final rule with comment period continues recent efforts by the CMS to improve the accuracy of Medicare Physician Fee Schedule payment rates by implementing Affordable Care Act mandates to identify and revise payment for misvalued services.

It also addresses concerns about potential physician self-referral by requiring physicians who provide computed tomography, magnetic resonance imaging or positron emission tomography scans in their own offices to notify patients that they may receive the same services from other suppliers in the area.

The rule will also implement key provisions in the Affordable Care Act to expand preventive services for Medicare beneficiaries.

The final rule will appear in the Nov. 29 Federal Register, and CMS will accept comments on certain aspects until Jan. 2, 2011.

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