CMA opposes proposed Medicare physician payment cuts The U.S. House of Representatives’ Ways and Means Committee is working to extend the “rural” work Geographic Practice Cost Index (GPCI) payment adjustment, which is set to expire December 31, 2017. In order to pay for the extension, the committee has proposed an overall cut to Medicare physician payments by identifying and lowering payments for “misvalued” services. In 2014, Congress included a physician-opposed provision in the Protecting Access to Medicare Act (PAMA), designed to hold down Medicare spending by requiring the Centers for Medicare and Medicaid Services (CMS) to identify ... December 28, 2017 Medicare Federal Legislative Advocacy, Geographic Practice Cost Index, GPCI, Medicare 0 0 Comment Read More »
2017 Medicare fee schedule includes $140 million in additional funding for primay care The Centers for Medicare and Medicaid Services (CMS) on Wednesday released the final 2017 Medicare physician fee schedule. The fee schedule transforms how Medicare pays for primary care through a new focus on care management and behavioral health, which is expected to result in an additional $140 million in payments next year for physicians providing these services. The 2017 physician fee schedule focuses on improving Medicare payments for services provided by primary care physicians for patients with multiple chronic conditions, mental and behavioral health issues, and cognitive impairment or mobility-related ... November 14, 2016 Medicare Fee Schedule, Geographic Practice Cost Index, GPCI, MACRA, Medicare 0 0 Comment Read More »
California GPCI fix implementation to begin in January Last week, the Centers for Medicare and Medicaid Services (CMS) released the final Medicare physician fee schedule for 2017, which begins implementation of the long overdue overhaul of California’s outdated geographic payment localities. The California Geographic Practice Cost Index (GPCI) fix will update California’s Medicare physician payment regions and raise payment levels for 14 urban California counties misclassified as rural, while holding the remaining rural counties permanently harmless (starting in 2018) from cuts. All California payment localities will transition to Metropolitan Statistical Areas. The transition to the new localities starts next ... November 8, 2016 Medicare Geographic Practice Cost Index, GPCI, Medicare 0 0 Comment Read More »
CMA urges CMS to recalculate practice expense data to reflect California's higher practice costs As required by law, at least every three years the Centers for Medicare and Medicaid Services (CMS) adjusts payments under the Medicare physician fee schedule to reflect local differences in practice costs. In the proposed 2017 Medicare physician fee schedule, CMS made nationwide updates to the geographic practice cost indices (GPCI) based on new wage, rent and malpractice expense data. Unfortunately, according to CMS, the malpractice and practice expense GPCIs went down in nearly every region of California, which would result in a 0.48 percent GPCI payment reduction in all ... September 22, 2016 Managed Care, Medicare Fee Schedule, Geographic Practice Cost Index, GPCI, Medicare, Regulatory Advocacy, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMA meets with CMS on implementing California GPCI fix California Medical Association (CMA) physician leaders recently traveled to Baltimore, MD, to meet with the Centers for Medicare and Medicaid Services (CMS) leaders responsible for implementing the California Geographic Practice Cost Index (GPCI) fix, which will overhaul California’s outdated geographic payment localities. CMA was represented at the GPCI meeting by Larry DeGhetaldi, M.D., division president of the Palo Alto Medical Foundation in Santa Cruz, and Edward Bentley, M.D., a gastroenterologist in solo practice in Santa Barbara. Both physicians have worked on the GPCI issue for CMA for more than a decade. ... April 4, 2016 Medicare CMS, Federal Legislative Advocacy, Geographic Practice Cost Index, Centers for Medicare and Medicaid Services, GPCI 0 0 Comment Read More »
Medicare Advantage plans to see a modest increase in payments The Centers for Medicare and Medicaid Services (CMS) announced this week that Medicare Advantage plans would see a 0.4 percent boost in payment rates for 2015. This small payment boost is a change from CMS's February proposal that would have reduced Medicare Advantage plans payment rates by 1.9 percent. This announcement comes on the heels of new data that predicts falling Medicare costs due to healthier baby boomers aging into the system. Healthier beneficiaries in Medicare have led to a downward drop in risk adjustment for the program. CMS has also ... April 16, 2014 Medicare Medicare, Medicare Advantage, GPCI 0 0 Comment Read More »
Congress passes California Medicare GPCI fix After 10 long years of lobbying efforts by the California Medical Association (CMA), Congress has finally passed a bill to update California's outdated Medicare localities. The long overdue fix will update California’s Medicare physician payment regions to the same Metropolitan Statistical Areas (MSA) used to pay hospitals and raise payment levels for urban counties misclassified as rural, while holding remaining rural counties harmless from cuts. The MSAs used to determine payment rates for hospitals are continuously updated, so that reimbursement accurately reflects local costs to deliver care. The physician payment ... April 4, 2014 Medicare Rural Health, Geographic Practice Cost Index, GPCI, Medicare 0 0 Comment Read More »
House passes year-long SGR patch, includes California GPCI fix This morning the U.S. House of Representatives passed a year-long patch to stop the Medicare 24 percent sustainable growth rate (SGR) cut on an unusual 30-second voice vote. Unable to come to an agreement on how to fund a permanent repeal of the badly broken formula, despite a bill with bipartisan, bicameral support, Congress appears poised to kick the can down the road for the 17th time in just 10 years. The California Medical Association (CMA) is extremely disappointed that Congress has been unable to find bipartisan funding sources ... March 27, 2014 Medicare Advocacy, GPCI, Medicare, SGR, Federal Legislation 0 0 Comment Read More »
