CMS proposes 'flat fee' Medicare payment plan: 8 insights

Written by Shayna Korol | July 27, 2018 | Print  |

CMS released a proposed plan July 27, which would affect approximately 40 percent of Medicare payments physicians receive, NPR reports.

Here are eight things to know:

1. The "Patients Over Paperwork" plan combines four levels of paperwork required for reimbursement and four levels of payments into one form and one flat fee per appointment.

2. There would still be separate filing systems for new and established patients under the plan.

3. The plan is open for public comment until early September.

4. The CMS plan offers a flat fee per office visit with a patient regardless of the physician's specialty.

5. According to rheumatologist Angus Worthing, MD, who chairs the government affairs committee for the American College of Rheumatology, the plan may lead fewer medical students to opt for specialties that require complex patient management.

6. Under the proposed system, physicians who need to spend more time with patients can file for an "add-on" payment of $67 per appointment.

7. If the Medicare payment changes take effect, private insurers may follow suit to use common billing procedures. Some Medicare advocates such as Medicare Rights Center President Joe Baker are urging CMS to postpone the changes and do a trial run.

8. CMS plans to enact Medicare fee schedule changes Jan. 1, 2019.

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