What's Happening with Medicare Payments?

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August 16, 2013
In this issue
» Bill to Repeal the SGR Moves Forward in Congress

» Medicare Fee Proposal Breaks New Ground

About this newsletter

The ACP Advocate is an e-newsletter, edited by the College's Washington, DC governmental affairs division, created to provide you, our members, with succinct news about public policy issues affecting internal medicine and patient care. To learn more about ACP's Advocacy and to access the ACP Advocate archives, go to www.acponline.org/advocacy.

Welcome to the August issue of The ACP Advocate

Today’s issue focuses on the latest happenings in Washington with Medicare payments to physicians.  First we bring to you a story about new legislation that could potentially repeal the sustainable growth rate (SGR) formula that has caused the repeated, heartburn-inducing threat of devastatingly large cuts to payments for the last decade.  This legislation, developed by the House Energy and Commerce Committee shows more promise than anything we’ve seen before.  The bill would repeal the SGR and begin moving Medicare payments toward new, innovative models.  Check out the article for more details and stay tuned this fall to see how the bill progresses in Congress.

Our second story for you today, also about Medicare payments, focuses on the proposed 2014 Physician Fee Schedule that was released in July.  One of the biggest impacts for internists will be the new Complex Chronic Care Management payment codes.  Once finalized by CMS, the new codes would, starting in 2015, authorize payments to physicians for the work that goes into managing your most complex patients outside of their actual office visits.  To be eligible for the new chronic care payments, physicians would have to demonstrate their practices have the capabilities needed to coordinate care effectively for patients with complex chronic disesases.
  Also of note in this fee schedule, CMS has not released a proposed conversion factor that would calculate the payment rates for 2014.  This is most likely related to the information in our first story, that they believe it is likely this will be the year that Congress finally acts to get rid of the SGR and that they will not need to put into effect the massive cut that should be scheduled for Jan. 1.

Congress comes back into town on Sept. 9 and we’ll have our first Sept. issue for you that Friday the 13th.  Until then, for more coverage of what's happening in Washington take a look at my award-winning blog, The ACP Advocate Blog by Bob Doherty. You can also follow me on Twitter @BobDohertyACP.

As always, please send your feedback and suggestions on this newsletter to: TheACPAdvocate@acponline.org.

Yours truly,

Bob Doherty
Senior Vice President
Governmental Affairs and Public Policy
American College of Physicians

In the news
» Bill to Repeal the SGR Moves Forward in Congress
  ACP executive cites 'specific tangible progress' as hopeful sign

A key committee in the U.S. House of Representatives has unanimously recommended legislation that would repeal the Medicare Sustainable Growth Rate and replace it with stable payment increases and new payme... » Click to read the full article

» Medicare Fee Proposal Breaks New Ground
  First-time payments for managing chronic disease are among likely changes

Medicare will pay physicians for helping patients manage complex chronic illnesses starting in 2015, according to a proposed physician fee schedule released by the Centers for Medicare and Medicaid Services... » Click to read the full article

In focus
Apply for ACP’s 2014 Washington Internship
Applications are now being accepted for the College’s Health Policy Internship for Resident/Fellow and Medical Student Members. The internship represents an opportunity for one resident/fellow member and one medical student member to develop legislative knowledge and advocacy skills through working directly with the College’s Washington staff. The internship will last for 4 weeks starting on April 28 and ending with ACP’s 2014 Leadership Day. The deadline to apply is Oct. 11.

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