The Centers for Medicare and Medicaid Services (CMS) recently published its proposed rule on the 2011 Medicare fee schedule, and I wanted to draw your attention to three important aspects. First, CMS is projecting a 6.1% cut to all services in 2011 based on the Sustainable Growth Rate (SGR) formula. Since the regulation is based on current law, the proposed rule assumes no action by Congress to block the 23% cut currently scheduled for December 1, 2010, meaning the 2011 cut would be additional.
As you know, we continue to work with our allies both in the provider community and on the Hill to avert the pending cut and seek a permanent solution. Due to uncertainty regarding the timing of potential legislative changes, the overall effect of the SGR on provider payments in 2011 remains unclear.
Second, the proposed rule indicates that the Physician Quality Reporting Initiative (PQRI) will provide a bonus of 1% in 2011 and 0.5% in 2012 through 2014. The bonus will apply to all Medicare charges. In addition, CMS is proposing to reduce the threshold of applicable cases that must be reported from 80% to 50% for claims-based reporting of individual measures. If adopted, this change would make it easier for practitioners to qualify for the bonus payment. In 2015, the program will change from voluntary to mandatory and carry a penalty for non-participation of 1.5% in 2015 and 2% in 2016.
Third, CMS is also proposing to revise the medical economic index (MEI), which may trigger changes in the payment formula. We will be examining the proposed rule to determine if and how any changes to the MEI will impact payment for psychologists’ services.
We will provide you with any additional pertinent information after we have fully analyzed this lengthy and complex rule in the coming weeks.
Jeff Cook, J.D.
Director of Field & State Operations
American Psychological Association Practice Organization
750 First Street, NE Washington, DC 20002
(202) 336-5875 (Office)
(202) 336-5797 (Fax)
jco…@apa.org (click to verify and reveal email)
Republished with permission: APAPO
No comments yet.