Medicare Physician Fee Schedule

Overview

On July 3, the Centers for Medicare & Medicaid Services (CMS) released the proposed 2015 Medicare Physician Fee Schedule. This proposed rule would update payment policies under the Medicare Physician Fee Schedule (MPFS) and makes other policy changes related to Medicare Part B payments.

AAFP Perspective

In a media statement released after the proposed rule became available, the AAFP claimed that if Congress had any question about the urgency of repealing the sustainable growth rate formula that determines Medicare physician payments, they need look no further than the proposed 2015 Medicare physician fee schedule. For the twelfth consecutive year, the annual proposed schedule reflects an SGR-mandated payment cut that ultimately threatens the health security of elderly and disabled Medicare beneficiaries and the military families who depend on Tricare for their health coverage. The AAFP is disappointed that current law continues to require the Centers for Medicare & Medicaid to issue a physician fee schedule that slashes payment by 20.9 percent next year.

Moreover, failure by Congress to repeal the long-standing SGR overshadows the 2015 proposed fee schedule’s new and commendable code for chronic care management services.  Elderly and disabled patients have complex, multiple and chronic health conditions that require whole-person medical attention available only through primary care physicians. This code recognizes the value of additional cognitive and administrative work that occurs outside the exam room but that is essential to comprehensive, coordinated care. The AAFP welcomes the new code but looks forward to a day when policies designed to strengthen primary medical care are not undermined by drastic cuts to the underlying foundation on which all payment is based.

The AAFP again calls on Congress to repeal the flawed sustainable growth rate formula reflected in the 2015 proposed Medicare physician fee schedule. Congress could end this recurring cycle by passing the SGR Repeal and Medicare Provider Payment Modernization Act. Failure to do so means legislators will fall back on a time-consuming, expensive and destabilizing temporary patch. Temporary fixes do nothing to solve one of the most chronic and fundamental challenges in the Medicare program, nor do they establish a stable environment in which physicians can plan for their practice’s stability.


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