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Changes to your Medicare reimbursement formula

Physician Practice Advisor, July 19, 2005

New legislation could change the way that doctors are reimbursed by Medicare. In a letter to the CMS, Reps. Bill Thomas (R-Calif.) and Nancy Johnson (R-Conn.) made several suggestions on how to change the reimbursement formula.

Suggestions included:

  • Eliminating prescription drug expenses from the payment formula
  • Eliminating biologic expenses from the payment formula
  • Considering how new Medicare benefits affect physician costs

The letter also stated that the time was "ripe to tie physician payments to quality performance." Currently, physician payments are calculated and changed using the sustainable growth rate.

To learn more about changes to the Medicare reimbursement formula, click here.

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