ASCs, Physicians Face Potential Payment Cuts in January 2013
Access ASCA's Government Affairs Update report here.
This week, the Congressional Budget Office issued a report predicting a recession in the first half of 2013 if Congress fails to avoid the fiscal cliff the government faces at the end of 2012. Because Congress has not agreed on solutions for many tax and spending issues in 2012, more than $500 billion in tax increases and spending cuts are scheduled to take effect on Jan. 1, 2013.
The following changes would have a direct impact on ASCs:
• A scheduled 27 percent cut in physician payment, triggered by the SGR, the method CMS uses to update physician payments. The SGR was enacted by Congress in 1997 to control Medicare spending physician services. Since its inception, SGR has caused 11 potential reductions in physician payment, but Congress has delayed the cuts each year except 2002. Every time the cuts are delayed, the cost of "fixing" the SGR increases. If the scheduled reduction is not delayed this year, the physician rate cut will affect the 2013 ASC facility payment rate for procedures paid at the physician-office payment rate.
• A scheduled 2 percent cut to all Medicare providers. The cuts, beginning in 2013, should reduce the deficit by a total of $1.2 trillion over the next 10 years. If Congress does not delay the 2 percent cut and CMS makes no changes to the proposed 2013 ASC payment rule, which would enact a 1.3 percent increase in ASC payments, the combined effect would result in a 0.7 percent ASC payment reduction starting Jan. 1, 2013.
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