June 28, 2006
CMS Proposed Changes to Physician Fee Schedule Include Substantial Cuts to Anesthesiology
In the June 29 Federal Register, CMS is expected to propose a new practice expense methodology, as well as changes in work values stemming from the recently conducted Five Year Review. The proposal includes a 6% decrease in work payments for anesthesiologists, coupled with a 1% practice expense cut every year through 2010. This would amount to a 10% cut in Medicare payments to anesthesiologists over the next four years.
Other medical specialties are adversely affected by the CMS proposal, while some could see a significant increase in their payments. Of all medical specialties, however, anesthesiology faces the largest potential payment decrease.
ASA is working diligently to mitigate these devastating cuts. We are currently analyzing Medicare methodology for possible errors, are continuing our long battle to seek correction of Medicare’s undervaluation of anesthesia work, and have begun the formal comment process through CMS, arguing against these cuts. To address the practice expense reductions, for example, ASA remains committed to surveying for new data that could potentially force a reversal of the decreases proposed by CMS. ASA and others recognize that components of current CMS data for computing practice expense payments are too old to be valid. Along these lines, ASA has joined with the AMA and other large national medical specialties in commissioning a new survey of practice expenses that would be based on better and more accurate data.
The proposed cuts in Medicare payments to anesthesiologists are particularly troubling in light of ongoing problems with the SGR formula that adversely affects all of Medicare Part B physician services. ASA members are strongly encouraged to contact their Members of Congress now and through July to discuss the serious implications of the SGR and ask for a positive 2.8% update in 2007, as recommended by the Medicare Payment Advisory Commission. This is especially important if CMS implements further reductions to anesthesia payments.
Please contact your Representative and Senators through the Capitol Switchboard at (202) 225-3121 and ask them to repeal the unworkable SGR formula and replace it to with a system of positive updates based on the MEI. Additional explanatory materials are available below.
SGR Position Paper