2013 CMS Physician Fee Schedule Includes Payment for CRNA Chronic Pain Services
Centers for Medicare & Medicaid Services’ (CMS) Calendar Year (CY) 2013 Medicare Physician Fee Schedule proposed rule, which includes the controversial section regarding payment to CRNAs for chronic pain services, has been sent to the Office of Management and Budget (OMB) for review. The rule is scheduled to be issued as a final rule with comment period. This means that, while most of the rule will be effectuated on a final basis (as of 1/1/13), certain provisions of the otherwise final regulation will be subject to further comment from the public, though it is unclear whether the chronic pain proposal will be one of those provisions subject to additional comment.
Following the OMB review, American Society of Anesthesiologists (ASA) expects the final rule with comment to be promulgated on or around November 1, 2012. Most Anesthesiologist oppose this expansion of the scope of services rendered by CRNAs.
ASA Urges MedPAC to Reject SGR Draft Plans to Cut 18%
On October 5 and 6, 2011, the Medicare Payment Advisory Commission (MedPAC), the commission tasked with advising Congress on Medicare payment issues, will meet to review a draft recommendation that would help cover the costs of SGR repeal by cutting payments to specialty physicians, such as anesthesiologists, by nearly 18 percent over three years.
In a letter written to MedPAC in response to the proposed plan, ASA President Mark A. Warner, M.D., expresses strong opposition to the commission’s draft recommendation. Dr. Warner writes, “While we support permanently fixing the SGR, we believe cutting payment for anesthesia by 5.9 percent each year over the next three years, followed by a freeze in payment would harm patient access to care and does not take into account that Medicare currently pays anesthesiologists only 33 percent of the average commercial insurance payment for the same service.”
The proposed 10 year plan would differentiate specialty physicians from primary care physicians in regards to Medicare payments. For specialty physicians, the draft recommendation would reduce payments 5.9 percent annually in years 2012, 2013 and 2014, followed by payment freezes for the final seven years. Payments for primary care specialties would be exempt from the payment reductions and would instead be frozen at current 2011 levels for the entirety of the 10-year period.
ASA will continue to update members on the latest MedPAC developments.
