The ACR Regional Advisory Council (RAC) met in March to discuss reimbursement issues affecting rheumatologists in various regions. The RAC was established to assist physicians with reimbursement concerns.
Contact Congress Today about Medicare Reimbursement
Changing the Medicare physician reimbursement formula so that it more accurately mirrors the cost of care is a top legislative concern for the ACR this year. The reimbursement scale is currently calculated using the sustainable growth rate (SGR), which is based on the gross domestic product and is irrelevant to medical care. The formula has steadily decreased physician reimbursement since its inception.
Maximize Reimbursement by Managing Denials
Could you use an additional $50,000 to $80,000 in revenue each year? If you are like most clinicians, you have superbills and well-trained office staff but you still receive frequent denials. Though some denials are appropriate, many can be corrected and the lost revenue recovered.
Medicare Switch to ASP Pricing Reduces Part B Spending
The Medicare Payment Advisory Commission (MedPAC) reported to Congress in January that Medicare’s switch to a payment method known as ASP, or Average Sale Price, has reduced spending on drugs in the Medicare Part B program. This system reflects actual market spending, rather than wholesale prices.
Combine With Medicare Part D to Help Patients Afford Prescriptions
According to the 2003 U.S. Census, 29 million people in the United States make less than 200% of the federal poverty level and have no health insurance. Many persons have difficulty affording prescribed medications. In addition to Medicare Part D, there are more than 350 public and private patient assistance programs, including programs by pharmaceutical companies, that help patients pay for prescriptions.
Payments Cut to the Bone
CMS reduces reimbursement for DXA and vertebral fracture assessment
Medicare D-lemmas
Rheumatologists and patients report mixed experiences with the new prescription drug benefit
Control Quality Anxiety
Rheumatologists positive but cautious about their brushes with the quality movement
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