Congress Fixes Medicare Fee Schedule This month, speech-language pathologists and audiologists will find some relief from plummeting Medicare payments as Congress replaces a 4.4% decrease in payments with a 1.6% increase. The Congressional “fix” comes from the FY 2003 Omnibus Appropriations bill that will halt the downward spiral in the 2003 Medicare Fee Schedule conversion ... Policy Analysis
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Policy Analysis  |   March 01, 2003
Congress Fixes Medicare Fee Schedule
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Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   March 01, 2003
Congress Fixes Medicare Fee Schedule
The ASHA Leader, March 2003, Vol. 8, 3. doi:10.1044/leader.PA.08052003.3
The ASHA Leader, March 2003, Vol. 8, 3. doi:10.1044/leader.PA.08052003.3
This month, speech-language pathologists and audiologists will find some relief from plummeting Medicare payments as Congress replaces a 4.4% decrease in payments with a 1.6% increase.
The Congressional “fix” comes from the FY 2003 Omnibus Appropriations bill that will halt the downward spiral in the 2003 Medicare Fee Schedule conversion factor, which adjusts the base formula for all Medicare services. The bill contains a provision that increases the conversion factor 1.6% over the 2002 rate used in calculating Medicare payments. This provision became effective on March 1, according to Tom Scully, administrator for the Centers for Medicare and Medicaid Services (CMS).
The American Medical Association—and a coalition of health care associations including ASHA—led the charge on Congress, stating that with such dramatic cuts to the Medicare program, physicians and other health care providers would stop taking Medicare patients.
The Medicare law requires annual updates to the conversion factor, which is based on a mathematical equation taking into account many economic factors. The decreases in payment rates stemmed from underestimates of gross domestic product and the number of Medicare fee-for-service beneficiaries made by CMS for 1998 and 1999. CMS contended that they did not have the statutory authority to go back and revise the 1998–1999 figures.
Without a change in the law, the conversion factor would have continued to decline. In 2002, the fee schedule took a 5.4% cut and would have been decreased by an additional 4.4% this year. The recent legislative change allows CMS to go back and make the changes, resulting in a 1.6% increase in the conversion factor.
The change in the conversion factor will not affect the implementation of the new speech-language pathology and audiology CPT codes that went into effect this year, but will affect the reimbursement rates for these services. The new conversion factor took effect on March 1, although there may be some delay in the payment adjustments as CMS contractors update their payment systems.
ASHA’s preliminary analysis of the 2003 Medicare Fee Schedule, which was published in early January and can be found online , reflects the 4.4% decrease. Separate updated Medicare fee schedule analyses will be published in the near future for audiologists and SLPs that reflect this recent policy change, as well as other changes that have occurred, such as the delay in the outpatient therapy cap. ASHA will continue to work with CMS on this important issue and will provide updated fee schedule information and links to instructions on the new conversion factor from CMS on ASHA’s Web site.
For more information, contact Ingrida Lusis by phone through the Action Center at 800-498-2071, ext. 4482, or by e-mail at ilusis@asha.org ; or Mark Kander at ext. 4139 or by e-mail at mkander@asha.org.
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FROM THIS ISSUE
March 2003
Volume 8, Issue 5