Corporate Compliance

Medicare issues physician payment final rule

Compliance Monitor, November 7, 2007

CMS issued a final physician payment rule in order to improve the correctness of Medicare payments and to also give healthcare professionals and doctors more financial incentives. The hope is that this will provide a higher quality and value in the delivery of healthcare.

Provisions to the rule include:

  • Specifying requirements under the competitive acquisition program for Part B drugs for verifying that a drug ordered by a physician has been administered
  • Modifying enrollment standards for independent diagnostic testing facilities
  • Adding certain ophthalmologic imaging procedure to the list of procedures subject to the Deficit Reduction Act of 2005

Medicare will pay approximately $58.9 billion to 900,000 physicians and healthcare professionals and the quality incentive rates, revised payments, and policy changes will become effective January 1, 2008.

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