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The National Association for Medical Direction of Respiratory Care

The Washington Watchline

CMS Methodology for Measuring Physician Costs

Over the last three years, CMS has been developing the value-based payment modifier (VBPM) for the Medicare Physician Fee Schedule. The Affordable Care Act requires the VBPM to be phased in beginning in 2015 and be complete in 2017, when it would apply to all physicians.

The Impact of Comparative Effectiveness Research

With passage of The American Recovery and Reinvestment Act of 2009 (ARRA 2009) Congress authorized the Administration to spend $1.1 billion to develop a federally directed Comparative Effectiveness Research (CER) program. The majority of the initial expenditures were directed toward improving the capacity to conduct comparative effectiveness research through the establishment of a nationwide research architecture.

The Proposed 2015 Medicare Physician Fee Schedule

2015 will mark a significant turning point in physician compensation for services provided to Medicare beneficiaries. The Medicare Physician Fee Schedule for 2015 continues to implement significant changes to CMS policies and the regulatory environment.

Will Congress Repeal the SGR?

Tired of waiting for SGR repeal? No worries, despite the flurry of activity in Congress last year and the ongoing public discussion it will not happen. Revision of the conversion factor for the Medicare physician fee schedule as determined by the SGR formula has been a priority for our national societies since 2002 when we first experienced a reduction in Medicare reimbursement for our services.

The 2015 regulations affecting physician, hospital inpatient and hospital outpatient rules

On April 30, The Centers for Medicare and Medicaid Ser-vices (CMS) released the Inpatient Prospective Payment System (IPPS), for Fiscal Year 2015, containing changes to the Medi-care payment policies and rates for hospitals. When finalized in August, the changes will apply to discharges occurring on or af-ter October 1, 2014. Several of the proposals will have a direct impact on pulmonary and critical care medicine practices.

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