AAFP Board Chair Robert Wergin, MD, implored leaders of the House Committee on Energy and Commerce to expand the policy of site-neutral payments for physicians.
Here are seven key points:
1. Last November, Congress passed the Bipartisan Budget Act, which worked to equalize payments for physicians' services across practice settings.
2. Despite the legislation, many office-based physicians received lower payments for the same services as physicians in the hospital outpatient setting. JAMA published a study in December 2015 which found payments for physician visits at hospitals were $68 higher than those at stand-alone offices.
3. In his letter to Congress, Dr. Wergin said, "We strongly urge lawmakers to stand by this site-neutral payment reform, especially now when some hospital outpatient departments are seeking exemptions from this new payment policy."
4. Starting January 2017, physicians will be compensated either according to the Ambulatory Surgical Physician Payment Schedule or Medicare physician fee schedule depending on their practice location. However, the law allows some hospital facilities to continue charging higher rates for an evaluation and management visit. Those physician practices acquired by a hospital prior to Nov. 2, 2015 are exempt from the requirement.
5. While hospitals are eligible to obtain a facility fee from Medicare, physicians practicing in stand-alone offices are not eligible for the same fee.
6. The Obama administration, Congress, the Medicare Payment Advisory Commission and the GAO recognize the site-neutral payment reform's value as it would control costs without compromising patient quality.
7. While the CMS does not have the authority to address the disparity in Medicare payments across practice settings, Congress has the authority to change the policy to compensate physicians equally.
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