Most of you probably are now aware that the House and Senate approved legislation last week preventing implementation of a 24.9% cut in Medicare physician payments scheduled to take effect on Jan. 1, 2011. The “Medicare and Medicaid Extenders Act of 2010” (also known as H.R. 4994) extends current Medicare payment policies until Dec. 31, 2011.
However, did you know that in addition to preventing cuts in physician payments, H.R. 4994 extends several provisions set for expiration on December 31?
Most notably of those provisions, is a 12-month extension for the “work” geographic practice cost indices or GPCI for all geographic regions. This provision is important to most rural communities and states and provides equity in payments in relation to larger urban areas.
Additionally, the legislation provides $200 million to the Centers for Medicare and Medicaid Services to process and pay claims filed during 2010 that are eligible for higher payments as a result of changes in legislation.
These stop gap measures are helpful but we still have a lot of work to do with the 112th Congress and the Administration to develop a fair and equitable payment formula that incorporates new health care concepts like the Patient-Centered Medical Home.
What would you like to see in a long-term Medicare Physician Payment formula?