Medicare Compliance & Reimbursement

Plus: Payers may not honor new outpatient therapy cap amount until April, CMS says. If the Centers for Medicare & Medicaid Services has its way, the salad days could be over soon. This year, CMS will shell out six percent more for Medicare physician and clinical services -- but that amount will drop next year, if the SGR formula goes into effect. According to a Feb. 24 CMS press release, growth in national health expenditures will decelerate in 2010 to 4.6 percent, thanks to the projected 21 percent cut to Medicare physician payment rates required under the sustainable growth rate (SGR) "called for in 2010 under current law." Potential good news: CMS does acknowledge in its press release that "in every year since 2002, Congress has acted to override application of the SGR formula to reduce physician payments." Keep an eye on MLR -- we'll be following Congress and whether its members act [...]