Part B Insider (Multispecialty) Coding Alert

Plus, Bush's proposal makes beneficiaries pay more

When President Bush proposed $178 billion in Medicare cuts over the next five years in his 2009 federal bud-get, healthcare practitioners braced themselves for the source of those cuts. Although Bush's budget hasn't yet been approved, the U.S. House of Represen-tatives released a report outlining where those cuts would hit--and they will impact the wallets of almost everyone.

According to the House Budget Committee-s Summary and Analysis of the President's 2009 Budget, released on Feb. 7, the $178 billion will be culled from various aspects of the Medicare program over the next five years, with Part B providers im-pacted most as follows:

- Cut inpatient and outpatient hospital update: saves $70.3 billion
- Cut SNF update: $11 billion
- Cut hospice update: $5.1 billion
- Cut ambulatory surgical center update: $1.3 billion
- Competitive bidding for clinical lab services: $2.3 billion
- Limit oxygen rental to 13 months: $3 billion
- 60-Month end-stage renal disease (ESRD) Medicare secondary payer status: $1.1 billion
- Establish income-related Medi-care Part D premiums: $3.2 billion
- Eliminate indexation of income-related Part B premium thresholds: $2.6 billion
- Create 13-month power wheelchair rental period: $0.7 billion

In a Feb. 15 statement, Sen. Edward Kennedy (D-Mass.) said, -The Administration has trumped up a phony crisis in Medicare to justify proposing deep cuts in quality health care for seniors while giving massive subsidies to HMOs and other insurance companies.-
Healthcare practices may find their Medicare patients complaining as much as the physicians, thanks to the new income-based premium increases for both the Part B and Part D programs.

-The system may work if it graduates the premium based on where you (the beneficiary) live, but they don't indicate they-re doing that,- says Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions. A geographic indexing system is crucial to any income-based budget reform, Co-buzzi says, -because someone in Alabama and someone in New York City may make the same amount, but it doesn't mean they have the same disposable budget.-