April 1, 2014

Dear MSN Clients and Friends,

Last Night, the Senate passed the "Protecting Access to Medicare Act of 2014," that  once again provides a temporary patch to the Medicare sustainable growth rate (SGR) and delays the planned 24% reduction in reimbursements slated to take place on April 1, 2014.  Instead the bill provides a 0.5% increase through calendar year 2014 and freezes the final rates through March 31, 2015.

The bill also provides for delaying the implementation of ICD-10 for at least one year.  Section 212 of the legislation prohibits HHS from implementing ICD-10 at any point before October 1, 2015.

Additional provisions will:

• Cut Medicare's facility payments to CT services furnished by physician offices, independent diagnostic testing facilities (IDTFs), and hospital outpatient departments that use older CT scanning equipment without NEMA's recommended dose reduction software by 5 percent in 2016 and 15 percent in 2017 and subsequent years.
• Requires referring physicians to consult physician-developed appropriateness criteria (clinical decision support) when ordering advanced imaging procedures for their Medicare patients. 
• Require CMS to disclose the data used for 2012's 25 percent multiple procedure payment reduction (MPPR) policy to the professional component (PC) of advanced imaging services.
• Requires the Centers for Medicare and Medicaid Services (CMS) to produce data used to justify 2012's 25 percent multiple procedure payment reduction (MPPR) policy to the professional component (PC) of advanced imaging services.
• Mandates future cuts to medical services greater than 20 percent (in comparison to the previous year) are phased in over a two-year period, beginning in 2017.
• Extend the Medicare Geographic Practice Cost Index (GPCI) floor (minimum) of 1.0 through March 31, 2015.
• Give greater authority/discretion to the Secretary of Health and Human Services for identifying and adjusting RVUs for so-called "misvalued codes" under the Medicare Physician Fee Schedule.