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Potential Medicare pay cuts coming in 2015; participation selections due Dec. 31

It's that time of year again – time for physicians to decide about their participation in Medicare. Physicians have until Dec. 31, 2014, to make changes to their status for 2015. In addition to the annual threat of steep payment cuts as a result of the sustainable growth rate (SGR) formula, another factor for physicians to consider is that 2015 will be the first year that the Centers for Medicare & Medicaid Services (CMS) will impose penalties under the value-based modifier (VBM) program for large medical groups of 100 ...

CMA leaders meet with Congress on Capitol Hill before election recess

California Medical Association (CMA) physician leaders were in Washington, D.C., for the last week of the Congressional session, reminding California legislators about priority physician issues, such as the repeal of the Medicare sustainable growth rate (SGR) and adoption of long-term Medicare payment reform. Congress has scheduled a very short lame duck session following the November election during which leadership on both sides hopes to come to an agreement on a spending bill to keep the government running. Earlier this year, both houses of Congress were very close to a permanent repeal ...

Fall 2015 is new implementation date for ICD-10

The Centers for Medicare and Medicaid Services (CMS) last week published a final rule, officially setting Oct. 1, 2015, as the new ICD-10 implementation deadline. The bill including a temporary patch of the sustainable growth rate (SGR), passed by Congress in April also included a delay in ICD-10 implementation, which was previously to begin on Oct. 1, 2014. The new deadline allows providers, payors and others in the health care industry time to ensure their systems and business processes are ready to go on Oct. 1, 2015. ICD-10 (The International ...

SGR patched through for another year

Today, the U.S. Senate passed a year-long patch to stop the 24 percent Medicare sustainable growth rate (SGR) cut that was to go into effect on April 1. The bill, which already passed the U.S. House of Representatives last week, provides a 0.5 percent physician payment update through December 31, 2014, and then a 0 percent update until April 1, 2015. The bill now goes to President Obama for his signature.   Congress was again unable to come to an agreement on how to fund a permanent repeal of the badly ...

House passes year-long SGR patch, includes California GPCI fix

This morning the U.S. House of Representatives passed a year-long patch to stop the Medicare 24 percent sustainable growth rate (SGR) cut on an unusual 30-second voice vote. Unable to come to an agreement on how to fund a permanent repeal of the badly broken formula, despite a bill with bipartisan, bicameral support, Congress appears poised to kick the can down the road for the 17th time in just 10 years. The California Medical Association (CMA) is extremely disappointed that Congress has been unable to find bipartisan funding sources ...

House passes budget with three month SGR patch

The U.S. House of Representatives today passed a bipartisan two-year budget deal that includes a three-month patch that will stop the 24 percent Medicare physician payment cut that would otherwise take effect January 1, 2014—and replace it with a 0.5 percent payment raise—which will give lawmakers a little more time to finalize the long-term Medicare payment reforms currently making their way through Congress.   The budget now goes to the U.S. Senate, which is expected to approve the measure next week.

2014 Medicare fee schedule confirms 24 percent cut

Demonstrating yet again how broken the Medicare sustainable growth rate (SGR) formula is, physicians will face a 24 percent Medicare payment cut next year if Congress does not seize the opportunity to put a stop to the formula's annual threat of drastic payment cuts. This figure was confirmed by the Centers for Medicare and Medicaid Services (CMS) last week, when the agency released its final physician fee schedule for 2014. The California Medical Association (CMA) is currently reviewing the final rule, which was released much later than usual because of ...

Highlights from AMA's 2013 interim meeting

More than 1,000 physicians gathered just outside our nation's capital for the American Medical Association (AMA) interim meeting. The delegates debated a large number of resolutions, establishing new policies related to the Affordable Care Act, culturally and linguistically competent care and the Medicare sustainable growth rate. A number of these resolutions were put forward by the California delegation. Below are highlights of some of the resolutions adopted as policy.   Medicare Payment Reform: Following robust discussion in various meeting venues, the AMA House of Delegates passed an amended resolution regarding repeal ...

Both houses of Congress working together in an unprecedented collaboration to repeal SGR

http:///On Thursday, the Senate Finance Committee and the House Ways and Means Committee released an unprecedented bipartisan and bicameral “discussion draft” proposal that would fully repeal the flawed Medicare Sustainable Growth Rate (SGR) formula. The draft legislation would not provide automatic payment increases for 10 years. However, starting in 2016 physicians can choose to participate in new payment models (such as medical homes) and qualify for 5 percent annual bonuses.   In 2017 and beyond, physicians remaining in the fee-for-service program can participate in a new “value-based performance payment program,” which ...