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CMS Releases Final Rule On 2011 Medicare Fee Schedule

American Flag flying proudAs you know, in July the Centers for Medicare and Medicaid Services (CMS) released its proposed rule on the 2011 Medicare fee schedule, which reflected an expected cut to all services as a result of the Sustainable Growth Rate (SGR) formula and changes to the Physician Quality Reporting Initiative (PQRI) payments, as well as revisions to the medical economic index (MEI) that would significantly negatively impact psychological and other mental health services. As it has done before, CMS proposed to disproportionately cut reimbursement for mental health and other cost-effective services, by as much as 5% overall for psychologists, to offset the ever-increasing cost of equipment, technology and overhead in the system.

American Psychological Association Practice Organization quickly went to work:

During the comment period, APA submitted a letter objecting to the cuts and arguing that psychologists should not be penalized for providing cost-effective services with minimal overhead.  A copy of the letter is available here.

In addition, the Practice Organization, with the grassroots support of the Federal Advocacy Network, persuaded a bipartisan group of 22 House members to signal their opposition to the MEI’s impact on mental health directly to CMS.  The letter is available here.

Despite psychology’s demonstration of strong support on the Hill for more thoughtful consideration of the disproportionate impact on mental health, this week CMS published its final rule, which includes a chart showing a 4% cut resulting from the MEI rebasing.  This reduction, slightly less than the originally proposed 5%, will be implemented on January 1, 2011, as well as the final 2% reduction in practice expense resulting from the four-year phase-in announced in 2006.

Given the short timeframe and current political upheaval, there is very little chance that Congress would be willing or able to fashion a remedy during the upcoming lame duck session.  As a result, we have begun to confer with our allies on the Hill and among other affected specialties to devise a strategy to address this reimbursement change and/or the process that leads to changes like these early in 2011.

However, this bad news from CMS further underscores the critical importance that Congress immediately address our other reimbursement priorities – halting the 23% SGR cut scheduled for December 1 and securing an extension of the 5% psychotherapy payment restoration we won for 2009 and 2010.  Please expect to hear from us in the days ahead to request your grassroots support on these essential priorities.

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

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