CMS unofficially releases proposed 2014 physician fee schedule

The Centers for Medicare & Medicaid Services' proposed 2014 physician fee schedule (PFS) unofficially released July 8, includes updates in payment policies related to chronic care management, telehealth, geography-based cost adjustments, and the physician quality reporting system (PQRS).

The proposed rule will appear July 19 in the Federal Register. CMS will accept comments on the proposed rule until Sept. 6, and will respond to them in a final rule with comment period to be issued on or about Nov. 1, according to an announcement.

Of special interest to primary care physicians, CMS has proposed to pay for non-face-to-face complex chronic care management services for Medicare beneficiaries who have two or more significant chronic conditions, Healthcare Finance News reported. These services include regular physician development and revision of a plan of care, communication with other treating health professionals and medication management.

Proving such services are rendered, however, may result in an increase in paperwork for physicians, as CMS intends to establish practice standards necessary to support payment for furnishing complex care coordination management services, HFN reported. But practices certified as patient-centered medical homes may be able to use that documentation to support their meeting of requisite standards, pending responses during CMS' open-comment period.

In addition, CMS has proposed using updated data to adjust payments under the PFS to reflect local differences in practice costs. Updates would reassess and change the weights assigned to the work, practice expenses and malpractice cost components of each of more than 7,000 physicians' services furnished to patients covered under Medicare Part B.

Finally, proposed changes to the PQRS program will have multiple implications, since CMS intends to use the data to support its rollout of value-based modifiers, created by the Affordable Care Act, as well as the Physician Compare website.

Nonetheless, "the proposed rule does not include any provisions on the physician fee schedule update or [Sustainable Growth Rate formula] as those calculations are determined under a prescriptive statutory formula that cannot be changed by CMS," CMS stated.

To learn more:
- read the announcement from CMS
- see the article from Healthcare Finance News
- here's the proposed rule (.pdf)

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