Alicia Ault

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

CHICAGO – After 5 years of discussion and attempts at passage, the American Medical Association’s House of Delegates adopted a conflict of interest policy to help guide physicians on the ethics of receiving pharmaceutical or device company funding for continuing medical education.

The House was asked to approve a report on financial arrangements prepared by the AMA Council on Ethical and Judicial Affairs (CEJA). But because so many members continued to be divided on what the AMA policy should be, the Reference Committee on Amendments to Constitution and Bylaws recommended that delegates put off any formal action and refer the matter yet again, this time to the AMA Board of Trustees.

When the resolution to refer came to the House floor, the vote was close, with 48% of delegates wanting to put off any action, and 52% voting against referral. Delegates were then asked whether to adopt the CEJA report. The vote was less ambiguous, with 60% voting in favor of adoption.

The report was supported by primary care delegations and many state delegations. Dr. Lori J. Heim, board chair of the American Academy of Family Physicians, said on the House floor that the latest iteration of the report addressed her organization’s concerns and should be adopted.

"I hope we can deal with this today rather than refer it back," said Dr. Heim, a family physician and hospitalist in Laurinburg, N.C. "The CEJA has found a compromise that we can all live with."

Dr. William Golden, a delegate from the American College of Physicians, and a professor of medicine and public health at the University of Arkansas, Little Rock, said on the House floor that "version 5.0 is ready for distribution," and urged passage of the policy.

Several delegates said that although most specialty societies have conflict of interest policies, it was important for the AMA to have its own.

But some delegates from surgical societies said that passage of the policy might harm important relationships between surgeons and industry. The American College of Surgeons spoke against adoption of the policy.

In the report, the CEJA said it recognized that it could have looked more broadly at conflict of interest issues, but decided to focus on pharmaceutical, biotechnology, and medical device company sponsorship of continuing medical education.

"Narrowing our focus to CME allows us to explore the complex considerations at stake in a manageable context and to provide practical ethical guidance on issues that increasingly challenge physicians as professionals," according to the CEJA report.

The CEJA concluded that "physicians should strive to avoid financial relationships with industry."

Instead, physicians should "cultivate alternative sources of support, should design and conduct educational activities so as to reduce costs, and should insist that content developers and faculty members not have problematic ties with industry, to ensure independent, unbiased, high-quality educational programming that best meets physicians’ needs and is accessible and affordable for all practitioners," according to the report.

The report recognized that "it is not always feasible, or necessarily desirable, for professional education to disengage from industry completely." In the cases where industry funding could not be avoided, "vigorous efforts must be made to mitigate the potential influence of financial relationships."

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

As expected, the Centers for Medicare and Medicaid Services proposed that physician fees for 2012 would be reduced by 29.5%. The proposed rule was released in the Federal Register July 1.

The reduction is required by the Sustainable Growth Rate (SGR) formula that was part of the Balanced Budget Act of 1997. But Dr. Donald M. Berwick, CMS administrator, said in a statement that the agency is hoping to find a way to avoid the statutory decrease.

"This payment cut would have serious consequences and we cannot and will not allow it to happen," Dr. Berwick said. "We need a permanent SGR fix to solve this problem once and for all. That’s why the president’s budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix."

The reductions could be deeper for some specialties – especially for radiation oncology and diagnostic imaging – based on the impact of the Physician Practice Information Survey. The changes would reflect the third year of a 4-year transition to new practice expense relative value units.

And more payment changes may be looming. The CMS said in a statement that it is proposing to continue its efforts to identify what it calls "potentially misvalued codes." As part of those efforts, it will be taking a look at all evaluation and management (E/M) codes to determine if they are undervalued. The agency also proposes to examine the highest non–E/M expenditure codes for each specialty to see if they are overvalued.

The agency said that the reviews will improve payment accuracy, in particular ensuring that primary care services are appropriately reimbursed. It’s the first time the agency has looked across all specialties, according to the CMS.

"We believe strong efforts are needed to evaluate Medicare’s fee schedule to ensure that it is paying accurately and ensuring that Medicare beneficiaries continue to have access to vital services, such as primary care services," Jonathan Blum, director of the Center for Medicare, said in a statement.

Diagnostic imaging has been a target for Medicare, and it is again in this proposal. The agency wants to extend the multiple procedure payment reduction (MPPR) policy to the professional component of advanced imaging services, which includes computed tomography (CT) scans, MRI, and ultrasound. The agency said the reduction would affect about 100 types of services. It is also the first time that the CMS has taken aim at the professional component of these services. That component would be reduced by 50% for subsequent procedures furnished to the same patient, on the same day, in the same session, resulting in an estimated $200 million in savings, according to the CMS.

For the first time, the agency is proposing quality and cost measures to be used in setting incentive payments for physicians who provide higher quality and more efficient care. That lays the groundwork for 2015, when the Affordable Care Act requires the CMS to begin making payment adjustments for certain physicians and physician groups. The requirement goes into effect for all physicians in 2017. The agency is proposing to use 2013 as the initial performance year.

In other issues addressed by the proposed rule, CMS seeks to add smoking cessation to the list of services that can be provided through telehealth. In the future, new services would be examined according to the clinical benefit they provide rather than on whether they are equivalent to a corresponding in-person service.

Finally, the CMS proposed some changes to the Physician Quality Reporting System, the ePrescribing Incentive Program, and the Electronic Health Records Incentive Program. The agency, for instance, is expanding the ways physicians can qualify for incentive payments under the meaningful use criteria.

Comments to the proposed rule can be submitted until Aug. 30; a final rule is expected by Nov. 1.

CHICAGO – A sampling of claims payments from some of the nation's top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued at the meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

“This report card conveys that the current state of the health care claims process is untenable,” AMA board member Dr. Barbara L. McAneny said at the meeting.

She said that 10%-14% of a physician's revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services, Humana, Regence, and UnitedHealthcare.

UnitedHealthcare (UHC) was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states, and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation's top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued at the meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

“This report card conveys that the current state of the health care claims process is untenable,” AMA board member Dr. Barbara L. McAneny said at the meeting.

She said that 10%-14% of a physician's revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services, Humana, Regence, and UnitedHealthcare.

UnitedHealthcare (UHC) was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states, and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation's top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued at the meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

“This report card conveys that the current state of the health care claims process is untenable,” AMA board member Dr. Barbara L. McAneny said at the meeting.

She said that 10%-14% of a physician's revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services, Humana, Regence, and UnitedHealthcare.

UnitedHealthcare (UHC) was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states, and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.