CMS Issues Proposed Rule on Physician Fees and Bonus Payments for Primary Care - July 7, 2010

On June 25, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would update payment rates under the Medicare Physician Fee Schedule and would implement provisions of the Patient Protection and Affordable Care Act (PPACA) related to primary care. The rule would provide incentive payments to primary care practitioners equal to ten percent of their Part B payments for primary care services, as well as incentive payments to general surgeons in health professional shortage areas (HPSA) equal to ten percent of their Part B payments for major surgical services. CMS has clarified that an eligible primary care physician furnishing services in a HPSA may receive both a HPSA physician bonus payment under the pre-existing program and a 10% bonus under the new program, but the new payment will be calculated without regard to existing HPSA bonus payment amount. Finally, the proposed rule would implement PPACA provisions to eliminate the 20 percent coinsurance for most preventive services, including new annual wellness visits. CMS will accept comments on the proposed rule through September 10, 2010.