More on proposed 2008 Medicare fee schedule

As mentioned in my blog post yesterday, the proposed 2008 Physician Fee Schedule included a  9.9% conversion factor cut. Medicare placed the fee schedule on its web site last week, although the proposed rule isn't expected to be published in the Federal Register until this week.

Here are some highlights of the rule according to Part B News (www.decisionhealth.com):

  • CMS shows its intent to expand the Physician Quality Reporting Initiative (PQRI) in 2008 by adding new quality measures.
  • Even CMS officials acknowledge that the Congress may well erase all or some of that 9.9% cut in legislative action later this year.
  • Calls for updates to work RVUs for 50 codes, as recommended by the Relative Value Update Committee (RUC) last year. Some of the changes would increase the work component of anesthesia services by 32%.
  • It proposes to create a new program to electronically send prescriptions.
  • The rule suggests a new way to calculate Average Sales Price (ASP) for drugs to better reflect the costs of bundled drugs.
  • It would add some ophthalmologic imaging procedures to the list of services that will be capped at the payment made in the hospital outpatient department.
  • The rule includes proposals to revise the physician self-referral provisions to help prevent fraud and abuse
  • It would change the enrollment standards for Independent Diagnostic Testing Facilities (IDTF).
  • The rule would require hemoglobin or hematocrit data to be reported on claims for drugs used to treat anemia secondary to anticancer treatment.
  • It would eliminate the exemption for e-prescribing and computer-generated fax prescriptions from Medicare prescription standards.

You can comment on these proposals until Aug. 31.


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