Part B Insider (Multispecialty) Coding Alert

Published on Fri Aug 04, 2006 PDF

Commission proposes reforms in RVU setting methods

Congress should give you a 2.8 percent pay increase next year, the Medicare Payment Advisory Commission recommended in its semiannual report.

Don't start counting that money yet. MedPAC recommended a similar pay hike for 2006, and Congress gave you a pay freeze instead. But it can't hurt to have Congress' advisory body repeating its call for physicians to receive a fair pay raise.

MedPAC also called on Congress to create a new panel of experts to review the recommendations from the Relative Value Unit Update Committee (RUC). MedPAC is concerned that the specialists on the RUC are giving procedures too much of a pay hike, which spells a pay cut for primary care doctors.

Procedures should have an automatic five-year review if they've shown sharp changes in length of stay, site of service, volume, practice expense or other factors. And any services that are likely to see sharp decreases in expenses over time should receive an automatic review, MedPAC advises.

Medicare does undervalue primary care physicians' services, and risks a total collapse of primary care, C. Anderson Hedburg, president of the American College of Physicians, told the House Ways & Means Health Subcommittee in a March 1 hearing on the MedPAC report.

In other news:

• The Centers for Medicare & Medicaid Services posted new information to help providers understand, obtain and use their new National Provider Identifier (NPI) numbers by the upcoming May 23, 2007 compliance deadline.

New application guidelines for providers who wish to obtain an NPI through the Electronic File Interchange ("bulk enumeration") process are now available at www.cms.hhs.gov/NationalProvIdentStand/07--efi.asp. Under the EFI process, providers and provider groups can have a separate EFI organization apply for an NPI on their behalf.

• You may soon find out whether the Deficit Reduction Act is the law of the land. Mobile, AL elder law attorney Jim Zeigler filed the first lawsuit disputing the DRA Feb. 13. There was a typo in the version of the law that President Bush signed, reflecting a slight discrepancy between the Senate and House versions of the law. No date for a hearing has been set for Zeigler's lawsuit.

• The American Medical Association corrected some minor errors in the 2006 CPT book. You can read the corrections online at www.ama-assn.org/ama/pub/category/print/3896.html.