On July 1, CMS announced proposed changes in 2012 reimbursement for physicians, hospital outpatient departments, ambulatory surgical centers and providers of dialysis services.
For physicians, the cuts will result in an overall 29.5% reduction in CMS payments for services provided to Medicare beneficiaries. While these cuts are required under the Sustainable Growth Rate (SGR) formula, Congress has acted in previous years to prevent the significant reduction in reimbursement rates. Furthermore, the President's budget proposal for the 2012 fiscal year would maintain the current payment rates to physicians until December 31, 2013.
With respect to hospital outpatient departments and ambulatory surgical centers, CMS announced a proposed increase in payments by 1.5% and 0.9% respectively. The proposed rule would also subject non-cancer hospitals to a 0.6% reduction to balance the increase in payments to cancer hospitals due to the budget neutrality requirement of the Affordable Care Act (ACA).
In sharp contrast to the announced cuts in reimbursement for physicians, CMS is proposing to increase payments for dialysis services by 1.8% for 2012, under the Prospective Payment System (PPS) that became effective on January 1 of this year. These proposed rules implement the annual adjustments required by the law that adopted PPS as the new reimbursement methodology for dialysis services. The 2012 year is the second year of a four year phase-in period for PPS. The "net" 1.8% increase is a combination of several adjustment factors that CMS is required to take into account annually to determine the 2012 reimbursement adjustment.
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