On Nov. 1 the Centers for Medicare & Medicaid Services (CMS) issued a final rule for services paid under the Medicare Physician Fee Schedule (MPFS) for the 2012 calendar year. Comments to the final rule are being accepted by CMS through Jan. 3, 2012.
An issue of great significance to our members is the payment cuts resulting from the effect of the sustainable growth rate (SGR) on the conversion factor, which is used to calculate payment for all services. The 2012 final rule indicates that, without congressional action, a conversion factor of $24.6712 will be in place effective Jan. 1, 2012. The conversion factor decrease reflects a cut of 27.4 percent, only slightly less than the estimated figure of 29.5 percent, which was listed in the 2012 proposed rule. This significant cut to the conversion factor will potentially have a devastating impact on the practice of sleep medicine and access to care for Medicare beneficiaries. The AASM encourages all members to contact their local congressperson or senator to explain the negative effects of the SGR on sleep practices.
AASM staff is in the process of reviewing the 1235 pages of the display copy of the final rule and will provide further analysis to members in future editions of the Weekly Update.
In addition to the Physician Fee Schedule Display Copy, CMS issued fact sheets on changes to physician incentive programs and the value-based payment modifier and physician feedback program. The AASM encourages members to review each of the CMS fact sheets.