CMS Releases 2014 Proposed Rules; ACCC Schedules Call for Members

Posted in ACCC News, Advocacy, In and Around Washington, DC by ACCCBuzz on July 10, 2013

U.S. Capitol By Matt Farber, Director of Provider Economics & Public Policy, ACCC

On July 8, the Centers for Medicare & Medicaid Services (CMS) released  the 2014 Physician Fee Schedule (PFS) and the  Outpatient Prospective Payment System (OPPS) proposed rules. ACCC is currently reviewing the rules and preparing detailed summaries for its membership. On Wednesday, July 24, from 2:00 – 3:00 pm ET, ACCC will host a conference call for members to review the rules and their potential impact on community oncology. ACCC members should be on the lookout next week for an email with the call-in details for the conference call.

At first glance, what’s on the horizon for 2014? Not surprisingly, there are some positives and some negatives.

On the positive side, under the 2014 OPPS proposed rule, drug reimbursement will remain at the current level of ASP+ 6%. Under the 2014 PFS proposed rule, medical oncology will see about a 1% reduction in Medicare payments.

The news is less positive for radiation oncology, which faces a 5% cut in Medicare payments under the proposed 2014 Physician Fee Schedule. These cuts are due to several factors, including a change in the utilization rate for equipment—from 75 percent to 90 percent—that was mandated by the American Taxpayer Relief Act of 2012. CMS is also reviewing potentially misvalued codes, and the agency is  seeking comments on how best to analyze the effects that consolidation has had on the Medicare system. As in both the proposed 2014 Inpatient Prospective Payment System (IPPS) rule and the proposed 2014 PFS, under the 2014 OPPS proposed rule radiation oncology will also see cuts. Most, if not all, of the APCs associated with MRI and CT testing will see double digit decreases in 2014. (Read ACCC’s comment letter to CMS on the IPPS 2014 Proposed Rule and Use of Separate Cost Centers for CT Scans and MRI Imaging here.)

Stay tuned for summaries and analysis from ACCC of the 2014 proposed PFS and OPPS rules. ACCC members, please join us on July 24 for our conference call on the rules.

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