The landscape of Medicare payment policy will be changing over the coming years as a result of actions taken in 2014 through the Medicare Physician Fee Schedule (MPFS) and the Protecting Access to Medicare Act (PAMA). The MPFS for 2015 contained fewer changes to current payment policy than it did proposals deferred for future consideration. The Protecting Access to Medicare Act of 2014 (PAMA) was initiated to avoid the significant Medicare payment reduction imposed by the Sustainable Growth Rate (SGR) provision in the Medicare law, but it also contained other provisions affecting payment under the Medicare program.
Here are the highlights of the MPFS Final Rule for 2015 that will have an impact in future years:
Film-to-Digital Practice Expense Valuation
Reporting Place of Service
Radiation Treatment Therapy
Global Surgery Packages
Secondary Interpretation of Images
The Protecting Access to Medicare Act (PAMA) was signed on April 1, 2014 and it also contained some provisions that will impact radiologists’ Medicare payments in years after 2015:
CT Radiation Dose Standards
Clinical Decision Making
Some of the rules described here cannot be affected by individual practices, but taking action on others will garner rewards in years to come. Practices that have older CT equipment will want to analyze whether or not it will pay to upgrade rather than receive lower reimbursement for scans on their older equipment. Radiologists have a big job ahead of them to convince referring doctors to use clinical decision support systems. However, participating in PQRS is a relatively easy way to avoid penalties beginning in 2017, and to perhaps generate increased reimbursement from Medicare. Healthcare Administrative Partners will continue to keep you updated on these and other changes that will affect your practice’s revenue. Be sure to subscribe to this blog for the latest updates.