It appears that Congress is finally determined to provide a permanent solution to the annual Medicare fee payment crisis, and there is a possibility that the process also could reduce pressure to end an exception to the Stark self-referral law upon which many urologists have come to rely.
The decisions by the men and women who are elected will determine whether physicians who treat Medicare are fairly reimbursed; whether the Independent Payment Advisory Board (IPAB) is allowed to continue; and even how government agencies, task forces, and advisory boards that make recommendations on specific testing and treatment protocols are allowed to function.
For urologists who strongly oppose key provisions of the Patient Protection & Affordable Care Act (ACA), upheld by the U.S. Supreme Court in late June, the best hope for change may lie in the ballot box rather than in the halls of Congress.
With all of the pressure on the federal government to curtail spending, the U.S. Department of Health and Human Services (HHS) is not kidding around when it comes to investigating and prosecuting Medicare fraud and abuse.
How would you like to have to go back for 10 years and figure out if the feds have overpaid you on a Medicare or Medicaid claim and then be required to pay up within 60 days or face monetary penalties and maybe get kicked out of federal health care programs? That's exactly what will happen unless a regulation proposed by the Centers for Medicare & Medicaid Services is significantly revised.
Finding a solution would seem to be a core issue for those interested in reforming a health care system in which Medicare is such a core component.
It has become increasingly doubtful that even if Congress passes some form of health care reform this year or in early 2010, reform of the formula on which physician Medicare payments are calculated will most likely not be included, and that is bad news.
Virtually lost in the debate over health care reform and whether it will contain a public option is an effort by advocates of medical malpractice reform to advance their cause and obtain some form of relief to the steadily increasing cost of premiums and the negative impact of defensive medicine.
The Centers for Medicare & Medicaid Services is in the process of finalizing proposed Medicare policies and payment rate changes for health care providers that would have significant impact on many urology practices.
AUA expressed 'strong opposition' to the health care reform legislation amendment eliminating the self-referral exemption for in-office ancillary services such as CT scans on the same day The Washington Post ran an article with the headline 'Doctors Reap Benefits By Doing Own Tests.'