General Compliance Question of the Week
August 4, 2008
Question:
Why does CMS continue to make cuts to Medicare physician payments, which
are then canceled by congressional action?
Answer:
Most of the actions taken by the Centers for Medicare & Medicaid Services
(CMS) are a result of some federal law. The physician reimbursement cuts
are required by the Medicare sustainable growth rate (SGR) formula, which
dictates that once the volume of physician services reaches a certain threshold,
payment for each individual service is decreased to remain within a predetermined
spending limit. Such reductions impose an arbitrary payment that does not
factor in the cost to physicians of providing services.
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