NCMS Addresses Proposed Medicare Physician Fee Schedule Rule for 2012

The NCMS this week commented on the proposed Medicare Physician Fee Schedule rule for calendar year 2012, as published in the Federal Register by the Centers for Medicare and Medicaid Services (CMS) on July 19, 2011. NCMS is particularly interested in how the rule will affect reimbursement to physicians and the ability of Medicare beneficiaries to access care.

In a letter to CMS Administrator Donald M. Berwick, MD, the NCMS:

  • Supports permanent replacement of the SGR for updating the Medicare physician fee schedule. The NCMS is concerned about the potential impact of drastic cuts in Medicare physician reimbursement fees if Congress fails to replace the SGR and scheduled cuts are allowed take effect in 2012.
  • Encourages the Secretary of the Department of Health and Human Services (HHS) to gain physician support and input in developing quality measures for all aspects of medical care for Medicaid patients. The NCMS believes that a rigid schedule of implementation of the value-based modifier for the Medicare Physician Fee Schedule is unrealistic and could lead to use of measures not supported by appropriate professional organizations and fail to provide reliable measures of value or quality.
  • Shares the concerns of the AMA and national medical specialty societies over the proposed expansion of the Multiple Procedure Payment Reduction (MPPR) Policy to include advanced imaging services. The NCMS urges the CMS to refrain from subjecting entire groups of procedure and imaging codes to blanket rate reductions, and instead focus efforts on ensuring Medicare beneficiaries receive necessary diagnostic services at appropriate times.

Click here to the read the letter to Dr. Berwick.

NCMS will continue to address these issues in collaboration with the AMA and other physician organizations. Look for updates in the Bulletin and at


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