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July 26, 2014

Centers for Medicare & Medicaid Services (CMS) Releases Physician Payment Rule

On Monday, July 8, 2013, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule implementing changes to the Medicare Physician Fee Schedule for calendar year (CY) 2014.  CMS estimates that absent Congressional action, physicians who treat Medicare beneficiaries will face a 24.4 percent cut in their reimbursement due to the Sustainable Growth Rate (SGR).  More information on the SGR is available here.

As part of this proposed rule, CMS is also proposing several changes to the Physician Quality Reporting System (PQRS), the Medicare Electronic Health Record (EHR) Incentive Program, the physician compare website, and the physician value-based payment modifier.  A CMS fact sheet on these proposed changes is available here.

Comments on the proposed rule are due on September 6, 2013.  A copy of the proposed rule is available here and will be published in the Federal Register on July 19, 2013.  A CMS fact sheet highlighting the proposed rule is available here.

©2014 Drinker Biddle & Reath LLP. All Rights Reserved

About the Author

Medicare Reimbursement and Health Policy Director

Anna Schwamlein Howard is the Medicare Reimbursement & Health Policy Director in the firm’s Health Government Relations team.

A nationally recognized authority on health care reform issues, Anna has considerable experience in government relations and regulatory affairs. Specifically, she has extensive knowledge with the Medicare Modernization Act, medical privacy and prescription drug issues, Medicare physician payment legislation, the Affordable Care Act, and other federal health issues impacting the lives of older Americans.

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