Part B Insider (Multispecialty) Coding Alert
'Vicious Cycle' Runs Over Physician Payments
Enjoy that 1.6 percent payment increase for 2003. It could be the last boost you see for some time. Forget about that 2.5 percent pay raise the Medicare Payment Advisory Committee promised doctors in its latest report. Physician payments will be lucky to escape with a shave and a haircut, if not an actual decapitation. That binge, plus worsening numbers for gross domestic product (GDP) growth, will lead to negative updates to the conversion factor that governs physician payments for 2004 and following years. "There will be a ripple effect for years to come," predicted Centers for Medicare & Medicaid Services Administrator Tom Scully at a physician Open Door Forum the same day the report came out. The Trustees' report predicts a negative 4.4 percent update in 2004, followed by negative 1.7 in 2005 and negative 1.9 percent in 2006. Physicians would see modest positive updates in 2008 through 2012 in the Trustees' scenario. In a March 20 letter to MedPAC, CMS predicted the 2004 update would be between negative 5.6 percent and 0.6 percent, but would probably end up around negative 4.2 percent.
The Medicare Trustees' report sealed physicians' doom. Released March 17, it claimed Medicare Part B spent 11.6 percent more in 2002 than in 2001. A "significant growth in the volume and intensity of services performed by physicians" contributed heavily to the increase, the report said.
Physicians have only themselves to blame for the lean times ahead, Scully claimed. Instead of the 2 percent increase in physician spending CMS had expected, spending went up a whopping 8 percent. Medicare cut physician payments 5.4 percent last year, and Scully said the new numbers proved the theory of "behavior offset," in which physicians increase the amount of services they provide to compensate for cuts.
"It's pretty obvious that physicians reacted to the negative 5.4 percent conversion factor by jacking up volume of services," Scully insisted. "Unfortunately, that keeps coming back around" in a "vicious cycle," he added.
Part B Insider (Multispecialty) Coding Alert
- PHYSICIAN PAYMENTS:
'Vicious Cycle' Runs Over Physician Payments
Enjoy that 1.6 percent payment increase for 2003. It could be the last boost you [...] - HIPAA HELP:
Piggyback Privacy Rule To Make Security Compliance Load Bearable
There's good news and there's bad news about the HIPAA security rule. The bad news [...] - PHYSICIAN PAYMENTS:
Can Anything Save Physician Payments?
Now it's clearer than ever that physicians will suffer negative updates for the next few [...] - MEDICAL REVIEW:
Order Lab Tests And You May Hear From Carrier Reviewers
You now have only two weeks, instead of three, to respond to suspensions, offsets or [...] - MEDICARE REFORM:
Is The Bush Medicare Reform Plan DOA?
Nobody ever accused fee-for-service Medicare of being simple, but you might find yourself pining for [...] - CODING:
Don't Overbill For Stable Nursing Home Patients
When the doctor drops by the nursing home, it barely seems worthwhile to bill the [...] - CODING COMPLIANCE:
4 Tips For Painless Lesion Excision Coding
Lesions: All physicians have to deal with them in one capacity or another, and they [...] - EVALUATION & MANAGEMENT:
Outpatient Teaching Doctors Face Confusion
When the Centers for Medicare & Medicaid Services unveiled new documentation requirements for teaching physicians [...] - COMPLIANCE:
Don't Be Too Forward, OIG Tells Carriers
The check may be in the mail - but you may never see it anyway. [...] - STUDIES & SURVEYS:
Less Is More, Says MedPAC
Some regions of the country are spending 60 percent more per patient on health care [...] - PRESCRIPTION DRUGS:
Lincare Contamination Leads To Investigation
To err may be human, but to track errors is the Food and Drug Administration. [...] - DRUG PRICING:
CMS Seeks Alternative To Inherent Reasonableness For Drugs
The trouble with bluffs is they wear off eventually. The Centers for Medicare & Medicaid [...] - INDUSTRY NOTES:
Doctors Need To Ballast Hot-Air Cost Balloon
It's partly doctors' fault that medical costs are shooting up, says one influential doctor. Mahendr [...] - CODING:
Surgically Remove Surgery From Aftercare Claims
Rehab practices may have welcomed the 30 new ICD-9 codes for postsurgical conditions [...] - LEGISLATION:
Medicare Escapes Narrowly From Cuts
The Medicare program has made a narrow escape from huge budget cuts proposed by Republican [...] - BUNDLING:
Call Carriers To Avoid Bundling Shortfalls
If home medical equipment providers and Part B therapists furnish supplies or care to a [...] - PRACTICE EXPENSES:
Oncologists Hope To Avoid RVU Pie Fight
Can the Centers for Medicare & Medicaid Services fix reimbursement for cancer care without having [...] - LEGISLATION:
House Committee Aims To Insulate ALJs From CMS
The House Ways and Means Health Subcommittee March 20 passed Medicare regulatory and appeals reform [...]
