The Centers for Medicare and Medicaid Services (CMS) issued a final rule with comment period that updates payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2012.
CMS is required to issue a final rule that reflects current law. Under current law, providers will face steep across-the-board reductions in payment rates, based on a formula—the Sustainable Growth Rate (SGR)—that was adopted in the Balanced Budget Act of 1997. Without a change in the law from Congress, Medicare payment rates to providers paid under the MPFS will be reduced by 27.4% for services in CY 2012—less than the 29.5% reduction that CMS had estimated in March of this year because Medicare cost growth has been lower than expected.
This is the 11th time the SGR formula has resulted in a payment cut, although the cuts have been averted through legislation in all but CY 2002. According to CMS, the Obama Administration is committed to fixing the SGR and ensuring these payment cuts do not take effect.
The final rule with comment period will appear in the November 28, 2011, Federal Register. CMS will accept comments on those provisions that are subject to comment until January 3, 2012, and will respond in the MPFS for CY 2013.