Medicare Compliance & Reimbursement

Starting January 1, physicians can see it to believe it.

Good news for physicians - the Medicare pay increase promised in the prescription drug bill enacted last month will go into effect right on time in 2004. Effective January 1, physicians can expect a 1.5-percent pay increase. Thanks to the Medicare Prescription Drug, Improvement and Modernization Act, physicians in rural and other areas of the country can enjoy Medicare increases of up to 4.8 percent as the Centers for Medicare & Medicaid Services adjusts payments to reflect area cost differences. And special congratulations to physicians practicing in Alaska, who will be receiving a 52-percent increase. Docs should keep an eye out for changes in the fees for injectibles and certain other drugs - Medicare will be reducing reimbursement from 95 percent to 85 percent of the April 1, 2003, AWP to reflect more closely the actual price charged by suppliers. Coming on the heels of a threatened 4.5 percent fee decrease back in November, the new provision will, according to Health and Human Services Secretary Tommy Thompson, "create incentives for physicians to continue to treat Medicare beneficiaries." The deadline to decide whether or not you want to participate in Medicare this year will also be rolled back to February 17. Lesson Learned: Physicians can breathe a sigh of relief that a 4.8 percent pay cut planned for 2004 has been forestalled.