Part B Insider (Multispecialty) Coding Alert

If the Medicare Payment Advisory Commission (MedPAC) ran the world, you wouldn't have to worry about where next year's payment updates were coming from. The Congressional Budget Office warns that you face a 10 percent cut in your Part B payments for 2008 if Congress doesn't act. But meanwhile, MedPAC recommended that Congress give you a nice 1.7 percent pay hike next year.

The truth is, neither MedPAC's carrot nor the CBO's stick are likely to become law. But both numbers will influence the Democratic-controlled Congress as it debates options for yet another rescue mission.

In the long term, Congress needs to come up with a replacement for the system that keeps coming up with those steep pay cuts year after year. At its January 9-10 meeting, MedPAC debated its recommendations to Congress on a long-term fix, which are due March 1.

MedPAC commissioners couldn't agree on whether to scrap the current formula or tweak it with a different target.

Possibilities: Expand the formula to consider all Medicare spending, account for geographic differences in spending, or share savings with thrifty providers. MedPAC put off voting on these issues until next month.