As reported last week in AMC/NOMA Notables, CMS issued a proposed rule with a comment period extending through Sept. 30. The rule was published in the Federal Register Monday and can be reviewed and/or commented on at the following address, referenced by its August 8th publish date: http://www.regulations.gov/AGCY_CENTERSFORMEDICAREANDMEDICAIDSERVICES.cfm
CMS says that it is currently forecasting an update of -4.3% for CY 2006, and anticipates further negative updates in later years. According to an ancillary report prepared by Deloitte & Touche LLP on the rule, Congress and the Bush administration appear at odds on how to prevent a negative rate of increase for the SGR. Congress is seeking changes in the formula by CMS, which argues that the statute prevents any changes from the administrations' side regarding the methodology for calculating it. Revisions of note include payment for billable drugs for ESRD facilities, imaging room expenditures and the geographic practice cost index. The financial consulting firm published an impact analysis of the major changes delineated by specialty, factoring the -4.3 percent update. In addition to revising the physician fee schedule, the proposed rule addresses a number of policies affecting Medicare Part B payments. Also, the proposal does not include a conversion factor calculation. Addendum B contains the RVUs for work, non-facility practice expense, facility practice expense and malpractice expense and all other information for services included in the physician fee schedule. A copy is available on the CMS website at: www.cms.hhs.gov/physicians/pfs/default.asp