Part B Insider (Multispecialty) Coding Alert

Published on Thu Sep 08, 2005 PDF

You may still receive a respite from the 4.3 percent cut that's slated to devastate your practice in January, if one influential member of Congress has her way.

Rep. Nancy Johnson (R-CT), chair of the House Ways & Means Health Subcommittee, signaled her determination to push ahead with her bill--H.R. 3617--to save physicians from pay cuts. H.R. 3617 would guarantee your practice a 1.5 percent pay increase in 2006 and 2007, and then pay increases based on an index of health care costs.

Drawback: Your physician would only receive the full increases in 2007 and 2008 if you reported quality data, and starting in 2009, you'd have to meet certain quality measures to receive your full pay increase. (See PBI, Vol. 6, No. 28.)

In a Sept. 29 hearing of the subcommittee, the second one on H.R. 3617, Johnson showed she remains focused on saving you from pay cuts and moving Medicare "into the 21st. century" with pay-for-performance (P4P). But ranking Democrat Rep. Fortney "Pete" Stark said Medicare needs some mechanism to control physician spending, because right now physicians can simply "play less golf," perform more procedures, and receive more money.

Explanation: Part of the problem is that when your physicians do more work, it sometimes saves Medicare more money on hospital care, but physicians don't get credit for those savings. Johnson has added an amendment to her bill to create a pool of money from both hospital and physician payments to reward your practice for managing care and providing end-of-life care to terminal patients.