Congressional Payment Fix – Good News/Bad News

by User Not Found | Mar 01, 2012
The good news is that Congress has struck a deal to avoid the 27.4% cut to Medicare payments to physicians scheduled for March 1st.

The good news is that Congress has struck a deal to avoid the 27.4% cut to Medicare payments to physicians scheduled for March 1st. The bad news is that once again they failed to find a solution to the sustainable growth-rate (SGR), instead delaying it until the end of the year, after the election. Dr. Peter Carmel, President and CEO of the AMA said, “People outside of Washington question the logic of spending nearly $20 billion to postpone one cut for a higher cut next year, while increasing the cost of a permanent solution by another $25 billion.”

Also beginning March 1st, Medicare payments for DXA scans performed outside of the hospital setting will be severely cut. This is the result of a second round of regulatory reductions. The first was the Deficit Reduction Act of 2006 that limited Part B imaging center payments to those of hospital outpatient rates. This lowered office-based reimbursement by 40% in 2007. Under the Affordable Care Act of 2010, DXA payments increased to 70% of the 2006 Medicare rate. This rate was set to expire at the end of 2011. The second was a change in the way CMS calculated the practice expense and reduced the physician work RVUs for DXA by one-third, as recommended by the AMA’s Relative Value Update Committee.

Joe Calandra CMO, Midwest Imaging Professionals
Joe Calandra - CMO, Midwest Imaging Professionals
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