Electrophysiology could take up to 40% hit with Medicare cuts

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The Heart Rhythm Society (HRS) has sent a rallying cry to its members to speak out against the recent cuts under the Medicare Physician Fee Schedule Final Rule for 2010.

“If Congress does not act to abate the 21.2 percent negative update under the sustainable growth rate (SGR) formula scheduled to take effect on Jan. 1, 2010, the outcome could result in a staggering 20 to 40 percent reduction in practice expense for some electrophysiology services,” particularly evaluation and management services, wrote Richard L. Page, MD, president of HRS, in a letter to society meetings.

The Centers for Medicare & Medicaid Services (CMS) released the final rule on Oct. 30.

HRS, along with the American College of Cardiology and other organizations, had advocated against CMS using data from the American Medical Association’s Physician Practice Information Survey to update the practice expense per hour rate used to calculate inputs for cardiology services. CMS decided to use these data, but agreed to transition implementation of the data over a four-year period, which, CMS said, will lessen the severity of payment cuts for 2010.

“This action must not understate the impact of the cuts for 2010 and beyond,” according to Page.

“Payment cuts this steep could also result in transfer of certain services currently performed in a physician’s office to the more expensive facility setting. Or worse, some private practices may be forced to shift to hospital ownership,” Page said.

The final rule includes a decision to discontinue payment for in office and initial hospital inpatient consultation services, which is “of great concern,” to HRS.

“This action will force heart rhythm professionals to use office and hospital Evaluation and Management codes to report the intensity and medical decision making required to diagnose complex cardiac rhythm and electrical abnormalities. Specialty providers, such as heart rhythm professionals, who provide a disproportionate share of specialized consultative services, will experience a significant decrease in their reimbursement due to the elimination of consultation codes,” said Page in the letter.

While HRS said it will continue to oppose these cuts, the society asked its physician members to partake in the process by writing to CMS, local representatives and senators. The society also asked its members to provide feedback to HRS about how these changes will negatively impact their practice.