Part B Insider (Multispecialty) Coding Alert

Medicare shouldn't rush into implementing pay-for-performance, members of Congress insisted in a July 27 hearing of the House Energy & Commerce Health Subcommittee. Representatives asked tough questions of Mark McClellan, Centers for Medicare & Medicaid Services administrator, in the second day of hearings on physician payment reform. They wanted to know why Medicare couldn't pay doctors their actual costs for providing care, and how Medicare expected to implement pay-for-performance (P4P) when many doctors have no health information technology.

-I-m concerned about the rush, as some of my colleagues are, to implement a system of nationwide pay-for-reporting,- said Rep. Lois Capps (D-CA). Some legislators worried about using a one-size-fits-all system of P4P for all specialties, and for solo practitioners in rural areas. Rep. Bart Gordon (D-TN) worried that P4P would be similar to the disastrous implementation of TennCare, a Medicaid managed care plan, in his state.