CMS Releases Final 2017 Medicare Physician Fee Schedule

AAFP President Voices Disappointment With Provisions That 'Fall Short'

November 04, 2016 01:42 pm News Staff
[Physician working at table on calculator]

Every fall around this time, America's physicians get a glimpse of what their Medicare payment will look like for the coming year. And so it came as no surprise when, on Nov. 2, CMS released the final 2017 Medicare physician fee schedule.(www.federalregister.gov)

 The AAFP shared its initial reaction to the fee schedule in a statement from AAFP President John Meigs, M.D., of Centreville, Ala., who expressed disappointment with provisions of the fee schedule that he said "fall short" of expectations.

Meigs singled out CMS' handling of misvalued code changes that achieved only 0.32 percent in net expenditure reductions. That fumble, he noted, means physicians won't get the anticipated payment increase called for by the Medicare Access and CHIP Reauthorization Act (MACRA).

Story Highlights
  • CMS recently released the final 2017 Medicare physician fee schedule.
  • The AAFP voiced disappointment with certain provisions in the fee schedule but commended CMS' overall commitment to primary care.
  • The AAFP specifically singled out its strong support for expanding the Medicare Diabetes Prevention Program.

"Since these changes do not fully meet the misvalued code target required by law, physicians will not receive MACRA's positive 0.5 percent update in 2017," said Meigs. "The 2017 Medicare physician fee schedule conversion factor will be $35.89, an increase of only 9 cents from the 2016 conversion factor.

"This result violates the spirit of the Medicare Access and CHIP Reauthorization Act," he charged.

Another area that drew Meig's attention was an issue the AAFP has been tracking since October 2015 -- now finalized with the fee schedule -- that deals with requirements physicians will have to meet to comply with appropriate use criteria for advanced diagnostic imaging.

"The AAFP has ongoing significant concerns about the disproportional burden primary care physicians will face when trying to comply with appropriate use criteria requirements," said Meigs.

"We believe these requirements will place more burdens on primary care physicians than on other providers and add an unnecessary level of complexity that severely overtaxes our members," said Meigs. He added that the AAFP was troubled that CMS had not found a way to align the program with the Merit-based Incentive Payment System.

Academy Gives 'Thumbs Up' to Some Provisions

Some portions of the final fee schedule did garner an AAFP "thumbs up" -- in particular, CMS' overall commitment to strengthening primary care and patients' access to high-quality health care.

For example, Meigs welcomed the inclusion of additional codes for chronic care management, mental and behavioral issues, and cognitive impairment or mobility-related disabilities, although he went on to express the AAFP's ongoing concern regarding "overly burdensome documentation requirements for these services and the level of complexity this adds to the provision of these services."

And Meigs vowed to continue the AAFP's advocacy work to change current policy that negatively affects patients by charging copays for accessing chronic care management services.

Meigs hit another positive note when he again proclaimed strong support for the fee schedule's expansion of the Medicare Diabetes Prevention Program,(www.cms.gov) a provision the Academy had applauded(56 page PDF) when it appeared in the proposed fee schedule.

CMS Press Release Stresses Positives

As always, CMS posted a press release(www.cms.gov) immediately after announcing the 2017 final fee schedule.

The press release highlighted the 2017 fee schedule's focus on primary care, including the increases in payment for chronic care management and behavioral health services, as well as the expansion of the Diabetes Prevention Program test model set to begin in January 2018.

"These policies will give significant support to the practice of primary care and boost the time a physician can spend with his or her patients listening, advising and coordination their care," said CMS Acting Administrator Andy Slavitt in the release.

Note that AAFP experts are giving the final 2017 fee schedule detail a close look. Stay tuned for the release of their summary of the complex document in coming days.

Related AAFP News Coverage
AAFP Calls for Revisions in Proposed 2017 Physician Fee Schedule
CMS Proposal Signals Significant Boost in Primary Care Payment

(8/24/2016)

Proposed Medicare Fee Schedule Emphasizes Primary Care's Value
AAFP Summarizes Elements Critical to Family Physicians

(7/18/2016)

More From AAFP
MACRA Ready: The Shift to Value-based Payment

Additional Resource
The CMS Blog
A Healthier Medicare: Focusing on Primary Care, Mental Health and Diabetes Prevention(blog.cms.gov)

(11/2/2016)