Medicare Rights Center Comments on Proposed Changes to Medicare Physician Fee Schedule

Last week, the Medicare Rights Center submitted comments in response to proposals from the Centers for Medicare & Medicaid Services (CMS) to update and change aspects of the Physician Fee Schedule. This annual, proposed rule includes specific information about the payment rate for select services as well as broad policy initiatives and changes.

Medicare Rights’ comments supported many of the changes proposed in this year’s rule. Notably, CMS proposed to increase payments to providers for care provided to beneficiaries with disabilities that affect their mobility in order to improve incentives for providers to make structural and equipment investments that will allow them to better serve this population. CMS also proposed to increase payment for a variety of care coordination and case management services provided to beneficiaries with complex care needs and multiple chronic conditions.

Medicare Rights also commented in support of increased transparency for Medicare Advantage (MA) and Part D plans–encouraging CMS to go forward with a proposal to release information about MA and Part D plan bids and other financial data. This information will be valuable to researchers and policy makers, but also to beneficiaries comparing the relative value of different Medicare options. To make this information even more useful Medicare Rights urged CMS to release more timely information rather than the four-year-old data contemplated in the proposed rule.

Importantly, the Physician Fee Schedule included a reminder to all Medicare providers that it is illegal to bill Medicare beneficiaries who are enrolled in the Qualified Medicare Beneficiary (QMB) Medicare Savings Program for any cost sharing, including deductibles, coinsurance, and plan copayments.. Too frequently, Medicare Rights hears on our national helpline from people in the QMB program who are improperly charged by their providers. These low-income individuals cannot afford out-of-pocket costs that they should, by law, not be charged, but may be intimidated or reluctant to inform their doctors of this protection. This makes regular reminders about these rules from CMS to Medicare doctors essential.

Read the comments.