Your SlideShare is downloading. ×
HELP STOP DRACONIAN CUTS IN MEDICARE PAYMENT FOR CARDIOLOGY ...
HELP STOP DRACONIAN CUTS IN MEDICARE PAYMENT FOR CARDIOLOGY ...
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

HELP STOP DRACONIAN CUTS IN MEDICARE PAYMENT FOR CARDIOLOGY ...

949

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
949
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
1
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  1. HELP STOP DRACONIAN CUTS IN MEDICARE PAYMENT FOR CARDIOLOGY SERVICES ISSUE: Effective January 1, 2010, CMS will begin implementation of Medicare payment cuts that will threaten access to services that are critical to the detection and management of heart disease. BACKGROUND: In the final 2010 Medicare Physician Fee Schedule Rule, CMS finalized extraordinary Medicare payment reductions for cardiology services. Under the final rule, Medicare payment for virtually all cardiology services would be reduced, with the most significant reductions slated for cardiac ultrasound (35% reduction by 2013) and nuclear cardiology (36% reduction in 2010 alone). The overall reduction for typical office-based cardiology practices is estimated at about 25% by 2013. This reduction comes on top of a reduction of almost 30% in Medicare payment for office-based cardiac ultrasound services that went into effect this year. These reductions are largely the result of CMS’s proposal to use data from the new AMA Physician Practice Information Survey (PPIS) to determine the Medicare payment for practice expenses, such as equipment, supplies, salaries of non-physician clinical staff, and overhead. WHY STOP THE CUTS? • CMS finalized its proposal to use the PPIS survey over the objections of 124 legislators, without full analysis or adequate explanation. • The impact of the cuts on the provision of cardiology services throughout the country will be enormous, yet CMS did not subject the PPIS data to the rigorous statistical standards that were applied to the cardiology survey and numerous other surveys currently in effect. • In fact, CMS did not even request from the AMA a description of how the practice expense/hr data was computed, how the sample was selected, or what weighting method was used until ten days after the expiration of the public comment period. • Only a handful of specialties met the survey’s stated goal of 100 respondents per specialty. The cardiology practice expense per hour data are based on responses from only 55 respondents! • CMS’ own contractor fundamentally concluded that the ‘type of cardiology practice” included in the PPIS is not representative of the full range of cardiology practices as a whole, noting that the PPIS data is not consistent with a number of external benchmarks of cardiology practice costs. • While CMS states that the cuts are to be transitioned over four years to alleviate the impact on negatively impacted specialties, cardiology is by far the specialty that will
  2. incur the greatest losses, and fully half of the cardiology cuts will go into effect on January 1, 2010, unless Congress acts. • Most of the funds cut from cardiology, medical oncology, clinical social workers, clinical psychologists and others as a result of using the PPIS data are not redistributed to primary care providers. • These cuts do not take into account additional Medicare payment reductions that are included in the House and Senate health care reform bills. Specifically, both the House and the Senate health care reform bills would modify the assumption regarding utilization of nuclear cardiology equipment, which would result in additional Medicare payment reductions for nuclear cardiology—among the services hit hardest under the 2010 Physician Fee Schedule Rule. • The reductions slated in the final rule have already caused many cardiologists to sell or consider selling their practices to area hospitals, where Medicare payment for cardiology services is considerably higher, and Medicare beneficiaries will be required to pay substantially higher copayments. • The reductions especially threaten access in rural areas, which are currently served by satellite offices that would be financially unsustainable if the 2010 Physician Fee Schedule Rule is implemented. Cuts of this magnitude will impact the quality of services provided to Medicare patients with heart disease. Such cuts will influence the ability of physicians to hire and retain qualified cardiac sonographers, maintain and upgrade equipment, and generally continue to provide high quality services to their patients, especially in office settings. REQUEST: The cardiovascular community requests that all members of the House of Representatives contact Congressman Gonzalez (D-Texas) to sign on as a co-sponsor of H.R. 4371 intended to preclude these drastic reductions from going into effect and urges all members of the Senate to consider signing on to a letter to Senate Majority Leader Reid requesting that the health care reform legislation or other appropriate legislation include a provision that averts or substantially mitigates these disastrous reductions.

×