November 3 , 2006
CMS final rule for 2007 Physician Fee Schedule includes devastating cuts for anesthesiology—
ASA members MUST take action urging Congress to fix the SGR
The final rule for the 2007 Physician Fee Schedule, which CMS is set to release on Dec. 1, includes provisions that would amount to a shocking 13.7% reduction in Medicare payments to anesthesiologists beginning Jan. 1, 2007.
These cuts—which stem from the unfair SGR formula, and implementation of both the Five Year Review redistribution of "physician work" valuesand a new practice expense methodology—translate into a national average anesthesia conversion factor of $15.34, down from $17.77 in 2006. The SGR formula’s application is set to be negative 5.0%, absent Congressional action to the contrary this fall, before January 1, 2007.
All of medicine is taking an added hit in 2007, due in part to CMS choosing to apply the budget neutrality adjustment, mandated by changes in work values resulting from the Five Year Review, to the work RVUs assigned to services and procedures, rather than by simply adjusting the conversion factor. This action, which was opposed by most medical specialties, hurts anesthesiology more than most other specialties.
ASA has vigorously opposed all these cuts since they were originally proposed by CMS and published in the June 29 and Aug. 22 editions of the Federal Register. In addition to submitting strong formal written comments, to be on record with Medicare’s rulemaking process, ASA has analyzed the Medicare PE methodology for possible errors, including the failure to increase anesthesia values to fully reflect new, higher values for the evaluation and management services on which they are based. We are continuing our long battle to seek correction of Medicare’s gross undervaluation of anesthesia work within CMS and its processes. Further, ASA leaders have had face-to-face meetings with senior CMS officials to express adamant opposition to these reductions, and to explore possible solutions. These efforts will now be redoubled.
To help offset these egregious reductions, it is absolutely imperative that Congress take action to provide a positive payment update in 2007, as recommended by MedPAC. Every ASA member is strongly encouraged to contact his or her Representative and Senators at once. You may do so through the Capitol Switchboard at (202) 225-3121, or through the ASA CapWiz site.
As ASA continues working with CMS and Congress to address these dire payment issues, it is crucial that ASA members respond to Calls to Action, whether by contacting their Members of Congress, corresponding with CMS or taking other action as requested.