Practice Management Alert

Take note of several changes CMS hopes to make for 2008 to ensure you won't be blindsided if they take effect. Watch for these changes that CMS explains in its proposed plans for next year that were released on July 12:

• Quality: CMS unveils new quality measures in seven different categories that it wants to include in next year's Physician Quality Reporting Initiative (PQRI). The measures must win the approval of the National Quality Forum (NQF) or the AQA Alliance (AQA) to make it into the PQRI.
• The proposed new measures come from the AQA Starter Set, the NQF Ambulatory measure set, and some new measures being developed with the AMA. Medicare will continue to pay bonuses of 1.5-2.0 percent (or the capped amount, whichever is less) for reporting on quality indicators into 2008.
• IVIG: Medicare will keep paying for pre-admission services for intravenous infusion of immunoglobulin (IVIG), using temporary code G0332. This code is designed to reimburse you for the costs and resources involved in tracking down IVIG products for your patients.
• - Geographic index: CMS also updated its geographic index of physician practice costs to reflect newer data. This move may not, however, protect Medicare from a recent lawsuit by California counties that have lost out on physician reimbursement because of inaccurate data showing them as low-cost areas.
• Therapy: The proposed rule would also require physical and occupational therapists to meet their states- licensing, registration or certification requirements. And it would change the timeframes for certifying a therapy plan of care.
• Imaging: Medicare would still cap the technical component of imaging procedures at the hospital outpatient rate. And it would apply that cap to some ophthalmologic imaging services.
• Reporting: If your oncologist supplies patients with drugs to treat anemia as part of anti-cancer treatments, you would have to report the patient's hemoglobin or hematocrit data.
• Compliance: CMS would close some loopholes in the physician self-referral rules that the agency says have made the program -vulnerable to abuse.- In particular, you won't be able to mark up the cost of a diagnostic test that your practice purchased from another group or physician.
• E-prescribing: Computer-generated faxes would have to comply with normal standards for electronic prescriptions. Letting your computer create a fax was supposed to serve as training wheels for real electronic prescriptions, but now CMS is worried that doctors and pharmacies haven't moved beyond the fax yet.

For more information about CMS- proposals, go to www.cms.hhs.gov/center/physician.asp.