CMS Announces Drastic Reimbursement Cut

November 08, 2012

CMS released the 2013 Medicare physician fee schedule (MPFS) final rule, reducing reimbursement rates for physician services in 2013 by 26.5 percent — a drastic cut that AGA is committed to fighting.

Mark your calendar for Tuesday, Dec. 4, AGA Virtual Advocacy Day, when gastroenterologists will flood Congress with calls to stop the cuts. We must work together to ensure that patients have access to quality care and that physician practices remain viable for their communities.

CMS also released the final rule for payments to ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs), which includes increases in payment rates for 2013.

Medicare Physician Fee Schedule Final Rule

Review important changes for GIs.

By law, CMS is required to make these reductions, which can only be averted by an act of Congress. AGA understands and appreciates concerns about government spending, but believes steps must be taken to protect and strengthen the Medicare program. We support CMS in its call to Congress to fix the current sustainable growth rate (SGR) formula, which sets physician reimbursement. Before access to care is further threatened for the millions of patients who depend on the Medicare program, Congress must replace the SGR formula with a stable and equitable payment mechanism that reflects the costs of caring for Medicare beneficiaries and ensures access to high-quality care.

The rule will appear in the Federal Register on Nov. 16, 2012. CMS will accept comments on those provisions that are subject to comment until Jan. 2, 2013, and will respond in the MPFS for calendar year (CY) 2014.

Review the final rule. Read the CMS fact sheet.

ASC/HOPD Final Rule

Review important changes for GIs.

Payments to ASCs will increase by 0.6 percent, and payment rates under the outpatient prospective payment system will increase by 1.8 percent, effective Jan. 1, 2013.

The final rule will appear in the Nov. 15, 2012, Federal Register. CMS will accept comments on issues open for comment until Jan. 2, 2013, and will respond to them in the CY 2014 rule.

Review the final rule. Read the CMS fact sheet.

AGA is further analyzing the rules and preparing briefings on what GIs need to know. Continue to read AGA eDigest and the AGA Washington Insider for the latest updates.
 

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