MedPAC Advises 1% Update for Physicians
In its annual report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommended a 1-percent payment update for the physican fee schedule services in 2012.
MedPAC also recommended 1 percent updates in 2012 for outpatient dialysis centers, and hospice. For ambulatory surgical centers (ASCs), Congress should implement a 0.5 percent increase in calendar year 2012 while requiring ASCs to submit cost and quality data. Skilled nursing facilities (SNFs) would get no update in fiscal year 2012, according to MedPAC, which also called for Congress to establish a quality incentive payment for SNFs and for SNFs to report more accurate diagnostic and service-use information. MedPAC criticized the amount of fraud that occurs in home health agencies and advised HHS to redesign how it pays for home healthcare. The Commission also recommends that HHS investigate financial relationships and patterns of referrals between nursing homes and hospice and asked Congress to change Medicare’s payment to hospice.
This means that the anesthesia rates will go up slightly in 2012.
CMS Releases the 2011 Anesthesia Conversion Factor
The anesthesia conversion factor and the general conversion factor were modified as a result of changes to the Medicare Economic Index (MEI) as outlined in the 2011 final Medicare physician fee schedule database and as result of adjustments required by the Affordable Care Act.
These modifications resulted in a decreased general conversion factor, increased practice expense RVU, increased malpractice RVUs, and lower work values for chronic pain services and critical care services that will result in decreases to fees for many of these services. The negative impact of these decreases for pain practices and critical care services is about 8%.
Effects on the Anesthesia Conversion The anesthesia conversion factors for all localities (except Miami, Florida – which will remain the same and Queens, NY locality – which actually increased by 12 cents) have decreased slightly from 2010 to 2011. The average decrease in anesthesia conversion factors for those localities with decreases is approximately $0.54.
What does this mean for your anesthesia practice? Although, the big 25% Medicare fee schedule reduction was averted, calendar year 2011 will bring lower Medicare payments for anesthesia services as well as chronic pain care services. Due to the Patient Protection and Affordable Care Act and the Medical Economic Index, you will experience a minor decrease in the anesthesia conversion factor that will result in small reductions in reimbursement, but nowhere near the magnitude of what was expected earlier last year.
