CMS TO EXPAND MEDICARE PREVENTIVE SERVICES AND IMPROVE ACCESS TO PRIMARY CARE IN 2011

PROPOSALS WOULD IMPLEMENT AFFORDABLE CARE ACT BENEFITS

The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would implement key provisions in the Affordable Care Act of 2010 that expand preventive services for Medicare beneficiaries, improve payments for primary care services, and promote access to health care services in rural areas.  The proposed policies would apply to payments under the Medicare Physician Fee Schedule for services furnished on or after January 1, 2011.

The proposed rule would implement provisions in the Affordable Care Act that will eliminate out-of-pocket costs for beneficiaries for most preventive services, including the new annual wellness visit.  This visit augments the benefits of the Initial Preventive Physical Examination (IPPE or “Welcome to Medicare Visit”) with an annual wellness visit that allows the physician and patient to develop a personalized prevention plan that includes not only the preventive services generally available to the Medicare population, but additional services that may be appropriate because of the patient’s individual risk factors.

The proposed rule would improve access to primary care services by implementing an incentive payment for primary care services furnished by primary care practitioners that can include physicians, nurse practitioners, clinical nurse specialists and physician assistants.  The proposed rule would also implement a payment incentive program for general surgeons performing major surgery in areas designated by the Secretary as Health Professional Shortage Areas (HPSAs), would allow physician assistants to order post-hospital extended care services in skilled nursing facilities, and would pay certified nurse midwives for their services under the Medicare Physician Fee Schedule (MPFS) at the same rates as physicians.

To read the entire CMS Press Release issued today (6/25) click here: http://www.cms.gov/apps/media/press_releases.asp

CMS Issued Fact Sheets (6/25) with additional details at: http://www.cms.gov/apps/media/fact_sheets.asp

The proposed rule is available at:  http://www.federalregister.gov/OFRUpload/OFRData/2010-15900_PI.pdf

Or  http://www.federalregister.gov/inspection.aspx#special

CMS will accept comments on the proposed rule until August 24, 2010, and will respond to them in a final rule to be issued on or about November 1, 2010.  Except as otherwise  specified, the payment policies and rates adopted in the final rule will be effective for services on or after January 1, 2011.

This entry was posted on Monday, June 28th, 2010 at 8:34 am and is filed under MEDICARE UPDATES, NATIONAL HEALTHCARE NEWS. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.