GOVERNMENTMedicare pay-for-performance bill omits reimbursement formula fixThe decision of the Senate bill's sponsors to tackle quality and payment system reforms separately rankles physicians.By David Glendinning, amednews staff. July 25, 2005. Washington -- For doctors who are not prepared to embrace pay-for-performance in the Medicare program, recently introduced legislation raises the specter of mandatory payment reductions on top of the cuts they are already facing. A bipartisan group of senators late last month introduced a bill that would adjust Medicare reimbursement according to how well physicians and other program participants rate based on yet-to-be-determined federal quality-of-care measures. Doctors who were unable to begin reporting quality data to the government starting in 2007 would see an automatic 2% reduction in their Medicare update for each year that they don't participate. This penalty would be on top of whatever reductions are mandated by the physician payment formula, which is projected to cut doctors' pay by more than 4% in each of the next six years. The pay-for-performance legislation makes no mention of the upcoming rounds of cuts beyond a nonbinding "sense of the Senate" resolution that says Congress needs to fix the formula. Consequently, lawmakers and the White House could approve the bill without green-lighting separate legislation that turns the next couple of years of reductions into rate increases. A perception that the bill would penalize nonparticipants without any guarantee that the underlying payment system will be repaired prompted opposition from physician groups, including the American Medical Association and the American Academy of Family Physicians. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2005 American Medical Association. All rights reserved.
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