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Newsletter from Anesthesia Business Consultant
Conversion Factor
The general Medicare conversion factor, which applies to pain medicine, critical care, evaluation and management and other “flat fee” services, will decrease by 20.1 percent, to $27.2006. In March 2013, CMS had projected a CF decrease of 24.4 percent for 2014.
The announcement of a decrease should not raise an alarm: we are all accustomed to the annual two-step dance in which CMS applies the statutory Sustainable Growth Rate (SGR) formula, resulting in an arithmetic reduction, and then Congress overrides the cut in last-minute legislation.
In its explanation of the calculation of the new CF, CMS made clear its dislike for the reduction that the SGR compels:
By law, we are required to make these reductions in accordance with section 1848(d) and (f) of the Act, and these reductions can only be averted by an Act of Congress. While Congress has provided temporary relief from these reductions every year since 2003, a long-term solution is critical. We will continue to work with Congress to fix this untenable situation so doctors and beneficiaries no longer have to worry about the stability and adequacy of payments from Medicare under the Physician Fee Schedule. The Senate Finance Committee has scheduled a December 12 "open executive session" on the draft bipartisan proposal that would repeal the SGR and replace it with a mix of payment freezes and alternative payment models that reward physicians with bonuses for value and quality rather than volume
Conversion Factor
The general Medicare conversion factor, which applies to pain medicine, critical care, evaluation and management and other “flat fee” services, will decrease by 20.1 percent, to $27.2006. In March 2013, CMS had projected a CF decrease of 24.4 percent for 2014.
The announcement of a decrease should not raise an alarm: we are all accustomed to the annual two-step dance in which CMS applies the statutory Sustainable Growth Rate (SGR) formula, resulting in an arithmetic reduction, and then Congress overrides the cut in last-minute legislation.
In its explanation of the calculation of the new CF, CMS made clear its dislike for the reduction that the SGR compels:
By law, we are required to make these reductions in accordance with section 1848(d) and (f) of the Act, and these reductions can only be averted by an Act of Congress. While Congress has provided temporary relief from these reductions every year since 2003, a long-term solution is critical. We will continue to work with Congress to fix this untenable situation so doctors and beneficiaries no longer have to worry about the stability and adequacy of payments from Medicare under the Physician Fee Schedule. The Senate Finance Committee has scheduled a December 12 "open executive session" on the draft bipartisan proposal that would repeal the SGR and replace it with a mix of payment freezes and alternative payment models that reward physicians with bonuses for value and quality rather than volume