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®: CRE Regulatory Action of the Week

CMS Proposes New Medicare Payment Rules
The Centers for Medicare and Medicaid Services is proposing new rules that will have a significant impact on Medicare payments. One proposal will affect payment policies under the Physician Fee Schedule and will make other revisions to Part B (for CY 2011). This proposed rule changes the Physician Fee Schedule and other Medicare Part B payment policies to ensure that CMS' payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses, implements or discusses certain provisions of both the Affordable Care Act and the Medicare Improvements for Patients and Providers Act of 2008. In addition, this proposed rule discusses payments under the Ambulance Fee Schedule, Clinical Laboratory Fee Schedule, payments to ESRD facilities, and payments for Part B drugs. Finally, the proposed rule includes a discussion regarding the Chiropractic Services Demonstration program, the Competitive Bidding Program for Durable Medical Equipment and Provider and Supplier Enrollment Issues associated with Air Ambulances.

This proposed rule is so long and complicated that it has its own table of contents. Comments on the proposal are due 60 days after it is published in the Federal Register. It is scheduled to be published in the Register on July 13, 2010.

Click here to read an advance copy of the rule.

A second proposed rule changes the Hospital Outpatient Prospective Payment System and CY 2011 payment rates. This proposed rule revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and to implement changes arising from CMS' experience with this system. The proposal also implements certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act).

In addition, this proposed rule would update the revised Medicare ambulatory surgical center payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act.

This proposed rule also includes proposals to implement provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education and indirect medical education costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest.

Comments on this proposed rule are due by August 31, 2010. The proposed rule is scheduled to be published in the Federal Register on August 3, 2010. An advance copy of the proposed rule is available online here.