CMS Professional Reimbursement Schedule for 2002
The final rule on the Medicare professional fee schedule that was released on Nov. 1 will reduce average cardiology fees by approximately 8.4 percent, effective Jan. 1, 2002. The rule will bring about an across-the-board reduction of 5.4 percent for all physicians and other health care professionals who treat Medicare patients. This reduction is due in large part to a legislatively mandated update formula that is based on the gross domestic product and the amount of Medicare services provided by physicians. Thus, the slumping economy, combined with increases in physician services, played a significant role in the fee decreases.
The reduction is worse for specialties still experiencing reductions because of the phase-in of new practice expense values.This is the final year of that transition, and average cardiology fees will lose 3 percent from this change. The approximate reductions for specific cardiology subspecialty services are-echocardiography: 12 percent; electrophysiology: 11 percent; interventional: 14 percent; nuclear: 10 percent; general: 5 percent. Please note that these are approximate reductions for cardiology subspecialty services. The mix of services provided, however, will affect the actual impact in any physician office.
When news of significant reductions in Medicare physician fees reached the ACC several weeks ago, the College, in concert with the American Medical Association and other physician specialty societies, began working aggressively with the Centers for Medicare and Medicaid Services (CMS) and Congress to address the issue. The CMS has said it does not have the statutory authority to change the formula and that it requires a legislative fix. Congress, meanwhile, has been focused almost strictly on legislation related to the Sept. 11 terrorist attacks and appropriations. A number of “must-do” pieces of legislation have still not been passed, and Congress is essentially unwilling to act on anything that is not budget neutral. As a result, a legislative fix will be very difficult this year.
This is the highest-priority issue for the College, and the ACC will continue to push for administrative and legislative changes to mitigate the impact of the reductions, retroactively if necessary. More information on the College’s efforts will be communicated to ACC members in the coming days and weeks.
A spreadsheet with a breakdown of the fee schedule is now available at
http://188.8.131.52/advocacy/advoc_issues/MedicareFeesv3.xls, as well as an in-depth summary of Medicare fee changes for cardiologists in 2002 at http://184.108.40.206/advocacy/advoc_issues/medicaredetailed_1101.htm. The latter document includes a breakdown of significant ACC victories in gaining improved reimbursement for a number of cardiology procedures, available at http://220.127.116.11/advocacy/advoc_issues/medicaredetailed_1101.htm#procedure.
Concerned individuals are encouraged to share their concerns about the reductions with their congressional representatives, while acknowledging that Congress is preoccupied with other important matters. Given the significant reductions facing medicine, however, it is important that the College get congressional representatives’ attention on this issue. Please note that phone, fax, or e-mail are probably the best vehicles to reach members of
Congress, given heightened security associated with the US Mail service.