HHS issues yet another rule calling for 26.5% physician pay cut

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The Department of Health and Human Services released new rule proposals Thursday, including one that calls for a 26.5% statutorily required pay cut for Medicare physicians in 2013. The proposal also includes a new policy to pay a patient's physician or practitioner to coordinate the patient's care in the 30 days following a hospital or skilled nursing facility stay.

In a fact sheet discussing the Sustainable Growth Rate (SGR) methodology, HHS noted that Congress has overridden the required reduction every year since 2003. It added that the administration has said it “is committed to fixing the SGR update methodology and ensuring these payment cuts do not take effect.”

Meanwhile, a newly proposed Medicaid physician payment rule would boost doctors' pay levels to match Medicare's starting next year. HHS said the Affordable Care Act requires the Medicaid program to pay physicians in family medicine, general internal medicine, pediatric medicine, and related subspecialties at the Medicare levels in calendar years 2013 and 2014.

It's unlikely many doctors will see the higher reimbursements immediately. States have until March 31 to file paperwork with CMS to detail how they will pay out the money.

HHS said the Medicare physician rule also makes changes to two quality-reporting programs—the physician quality reporting system and the electronic prescribing incentive program.

The Medicaid physician rule (CMS-2370-F) is set for publication Tuesday in the Federal Register. The physician fee schedule rule under Medicare (CM S-1590-FC) is set for Nov. 16 publication.

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