The proposed 2009 Medicare physician fee schedule (MPFS) regulations published in the Federal Register on July 7, 2008, cover a wide range of topics that affect not just physician compensation, but also the manner in which physicians may provide and be paid for services other than traditional professional services. As in other years, the Centers for Medicare and Medicaid Services (CMS) is using the rulemaking to address subjects such as purchased services and standards applicable to independent diagnostic testing facilities (IDTFs). CMS also has proposed a new Stark Law exception relating to gainsharing and pay-for-performance programs, but does not address some of the other Stark Law issues that remain outstanding from prior rulemakings. This proposed rulemaking was published in the midst of congressional consideration of Medicare legislation that includes provisions affecting several key aspects of Medicare physician payment rates and policy. The legislation, which was approved by Congress on July 15, 2008, despite a presidential veto, affects this rulemaking in several ways. This White Paper summarizes some of the notable provisions of the proposed 2009 MPFS. In addition, more detailed discussions of the proposed diagnostic test “anti-markup” rule and Stark Law exception for gainsharing and pay-for-performance are found in two additional newsletters, "CMS Revisits the Diagnostic Test Anti-Markup Rule " and "Proposed Stark Exception Covers Pay-for-Performance and Gainsharing Programs ."
Please click here to view the entire White Paper in Adobe PDF format.
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