CMS delays 2003 Physician Fee Schedule, waits for Congress

Nov 7, 2002

The Centers for Medicare and Medicaid Services (CMS) is delaying publication of its final rule on the 2003 Physician Fee Schedule until Congress reconvenes November 12 following the recent election.

CMS said in a notice in the November 5 Federal Register that it had incomplete data to set the relative value units (RVUs) used in the fee schedule. The fee schedule is the product of a nationally uniform RVU for each service, a geographic adjustment factor for each physician, and a nationally uniform conversion factor for the service.

The conversion factor converts RVUs into payment amounts based on a formula linked in part to the U.S. gross domestic product (GDP). Although the GDP has declined over the past year, healthcare needs usually rise during an economic downturn.

Unless Congress intervenes, CMS will likely proceed with a proposed 3% reduction in global reimbursement in 2003, based on a 5.4% reduction in the conversion factor below 2001 levels. Legislation introduced by Sen. Jim Jeffords (I-VT) would set the physician payment conversion factor at 0.9% below 2001 levels.

Jeffords believes this would give Congress and the Medicare Payment Advisory Commission (MedPAC) time to conduct a study on developing a new formula that more accurately reflects changes in the costs of physicians’ services.

By AuntMinnie.com staff writers
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