- Sets 2014 payment rates for physician services
- Continues implementation of the physician value-based payment modifier by applying the 2016 modifier to groups of 10 or more eligible professionals
- Makes changes to criteria for earning a Physician Quality Reporting System (PQRS) bonus and avoiding penalties under this program. 2014 will be the last year a bonus will be available for PQRS.
- Establishes a separate payment beginning in 2015 for complex chronic care management services furnished to patients with multiple complex chronic conditions
- Modifies Geographic Practice Cost Indices (GPCIs) based upon statutory requirements and recommendations from the Medicare Economic Index Technical Advisor Panel
- Limits the payment for certain services where the physician fee schedule nonfacility payment is higher than the total payment to furnish the same service in a facility setting (either a hospital outpatient department or an ambulatory surgery center)
- Increases the amount of information about physicians and practices on the Physician Compare website, including quality measure performance
In addition to proposals in the rule, CMS states that the actual values used to compute physician payments for 2014 will be based on later data which are scheduled to be published by Nov. 1, 2013 as part of the 2014 PFS final rule. It refers to its analysis published in March that estimates an approximate 24.4 percent physician payment cut due to the sustainable growth rate formula (SGR).
For a copy of the full proposed rule on display click here. CMS posted a fact sheet on the proposed policy and payment changes and also released another fact sheet on the physician quality reporting programs and the value-based payment modifier.
As always, MGMA will prepare an in-depth analysis of the 652 page proposed rule for our members and will submit comments to the agency as well. Stay tuned to the Washington Connexion for further updates.