Cardiologists and others treating Medicare patients will receive around the same amount of payments in 2016, according to the proposed Medicare Physician Fee Schedule released on July 8. The Centers for Medicare & Medicaid Services (CMS) will release the final rule by Nov. 1.
The CMS proposal is the first since the Senate voted 92-8 in April to permanently repeal the sustainable growth rate formula, which had been in place since the late 1990s. Under the Medicare Access and CHIP Reauthorization Act of 2015, healthcare professionals will receive a 0.5 percent increase in payments through 2019.
However, the American College of Cardiology (ACC) noted that payments could vary widely depending on the type of practice and the services they offer. The Medicare Physician Fee Schedule pays for services such as office visits, surgical procedures, diagnostic tests, therapy services and preventive services. The schedule applies to physicians, nurse practitioners, physician assistants, physical therapists, radiation therapy centers and independent diagnostic testing facilities.
For 2016, CMS will not make noticeable changes to the Physician Quality Reporting System, according to the ACC. Most healthcare professionals must report at least nine measures in three domains. If they fail to do so, they will receive a 2 percent reduction in their payments.
CMS will also use the performance of physicians in 2016 to determine the Value-Based Payment Modifier in 2018. The modifier varies based on the quality of care compared with the cost of care. In 2018, it will apply to physician assistants, nurse practitioners, and clinical nurse specialists.
CMS is accepting comments on the proposal until Sept. 8. The ACC mentioned that CMS is interested in comments on implementation of the Merit-based Incentive Payment System, which goes into effect in 2019 and will be based on data from 2017.
The proposal does not include information on implementing appropriate use criteria for advanced imaging services, which will begin in 2017.