Medicaid payment final rule leaves out specialists

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Although family physician and internal medicine doctors are pleased with the higher reimbursements they will see in 2013, other specialties are feeling largely ignored by the Centers for Medicare & Medicaid Services' final rule issued Thursday. The long-awaited physician fee rule acknowledges primary care providers but leaves out emergency room physicians and OB/GYNs, among other specialty groups, Kaiser Health News reported.

Family doctors, internists and pediatricians next year will see Medicaid payments increase by up to 7 percent, estimated at $11 billion, according to American Academy of Family Physicians President Jeffrey Cain in a Thursday statement. These groups were specifically called out in the 2010 health law. OB/GYNs and emergency physicians sought to be included when CMS proposed rules in May but to little avail.

Radiologists and neurologists also were notably absent from the higher reimbursements.

"These are arbitrary cuts, and they make no sense," Geraldine McGinty, chairwoman of the American College of Radiology Economics Commission, told HealthLeaders Media about the schedule's 3 percent reimbursement cut to radiologists.

Neurologists could see up to a 7 percent fee cut from reduced payments, mostly from electromyology (EMG) and nerve conduction studies, according to Amanda Becker, director of medical economics and quality for the American Academy of Neurology.

Even though family physicians are initially pleased with the extra funding, AAFP President Cain acknowledges it's temporary--two years--and that Congress still must take permanent action.

 For more information:
- check out the CMS statement and final rule (.pdf)
- here's the AAFP statement
- read the Kaiser Health News article
- see the HealthLeaders Media article

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