The Centers for Medicare and Medicaid Services (CMS) Publishes 2008 Proposed Medicare Physician Fee Schedule: Physicians Face Significant Payment Cuts Unless Congress Acts

July 23, 2007 - CMS published its Proposed 2008 Medicare Physician Fee Schedule Rule on July 12.

As expected, CMS has proposed reducing physician payments by 9.9 percent in 2008. ASH is very involved in working with Congress to avert these drastic cuts. For the past five years, estimated cuts to the Medicare physician payment rate have been temporarily avoided through legislation. Currently, congressional committees in the U.S. House of Representatives are working on legislation to address Medicare physician payment that they hope to have voted on by the end of July. However, even with congressional action the best scenarios would be a .5 percent increase or a freeze in the 2007 conversion factor in 2008.

Similar to 2007, changes in the 2008 payment rates are once again impacted by a budget neutrality (BN) adjustment to physician work relative value units (RVUs), which decreases work RVUs by just over 10 percent in 2008. Additionally, CMS is continuing to phase-in a new methodology to capture practice expense costs. This new system has had a mixed impact on services commonly performed by hematologists.

The following charts reflect proposed 2008 payment rates for both the negative 9.9 percent update in the rule and the .5 percent update being considered by Congress.

ASH has developed a detailed summary of the rule, including information about proposals to report anemia quality indicators, compendia for medically accepted indications for off-label drug uses, the 2008 Physician Quality Reporting Initiative, payment for intravenous immune globulin (IVIG), and ASP issues. Comments on the proposed rule are due August 31, 2007, and a final rule will be published later in the fall. The final rule will be effective for services on or after January 1, 2008.

ASH's recommendations regarding changes to Medicare physician reimbursement, are available on-line.

In addition to viewing ASH's recommendations, ASH members are also strongly encouraged to join ASH's on-line advocacy campaign to prevent the physician payment cuts. Through ASH's Advocacy Center, physicians can quickly and easily contact their Members of Congress to urge a positive physician update.

If you have questions or need additional information, please feel free to contact the ASH Government Relations and Practice Department at grassroots@hematology.org or 202-776-0544.