CMS boosts Medicare physician payments for preventive services

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The Centers for Medicare & Medicaid Services proposed a rule Tuesday that would give a 1.5% payment increase to physicians caring for Medicare beneficiaries, thereby aiding the agency's shift to emphasize preventive services. The goal is to keep beneficiaries out of long-term care facilities. Under the rule, Medicare also will pay for initial comprehensive physical examinations for new beneficiaries starting Jan. 1, 2005.

"When it comes to modern healthcare, Medicare had it backwards, spending 99% of its resources treating seniors after they got sick and only 1% on preventing illness and promoting wellness," said Health and Human
Services Secretary Tommy Thompson. "With this new law, we are reversing this trend and focusing Medicare more on disease prevention and management."

The full physical includes influenza and hepatitis B vaccines, mammograms, Pap smears and pelvic examinations and screening tests for prostate cancer, colon cancer, glaucoma and osteoporosis, among other conditions. Medicare will also pay for an electrocardiogram; an assessment of a person's risk of depression; hearing and vision tests; and a review of a person's ability to perform activities of daily living, including bathing, dressing, eating and getting in and out of bed.

For the first time, the program would also cover screening tests for cholesterol and diabetes for people already in the program.