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The Short Answer
What does it mean for you and your practice? The short answer is honestly, not much. After reviewing a number of surprisingly politically-skewed and hyperbolic reports from prominent practice organizations in areas PBN focuses on, the long and short of it once you peer through the political veil is . . .
Medicare providers (not beneficiaries) may be subject to across the board reductions capped at 2%.
The More Detailed Version
Under the agreement passed last week, only Medicare providers would be at risk, and then only if a committee of 6 Democrats and 6 Republicans fails to agree on where to find enough reductions (half from the defense budget; half from "nondefense" programs). The Medicare reductions could also occur if congress fails to pass legislation based on the committee's findings.
When is 2% More Than 2%?
The legislation specifically precludes reducing Medicare payment adjustments based on any cost savings from healthcare reform efforts and other cost saving measures. The Health Care Fraud and Abuse Control Account (HCFAC) and similar efforts to curb Social Security Fraud are specifically mentioned. At the same time, the compromise includes a provision that Medicare payment adjustments may be included in addition to the 2% capped amounts if HCFAC funding exceeds currently budgeted amounts. The Congressional Budget Office estimates that these additional "savings" could result in as much as $3.7 Billion in lost revenue for Medicare practitioners over the next eight years (2012 - 2021).
The Rest of the Compromise
The other details of the compromise have a less direct effect on medical practitioners. For a more balanced summary of the implications of the act, take a look at the Congressional Budget Office summary available on PBN's website or directly from the CBO website.
Time to Pick Your Battles
Though these issues aren't nearly as much in the public eye or widely discussed among the general public, far more impactful as far as risked income for every Medicare practitioner are issues like the upcoming SGR Payment Reductions and other specialty-specific payment issues .
Instead of overreacting to a may-be 2% reduction, let's pay attention (and take action to fix) the 29.5% reduction scheduled for January 1, 2012 .
For more specific information about how the compromise may affect your practice and what PBN is doing to help, contact a PBN client liaison at .
For more information and guidance on this and other issues that affect your bottom line, contact . . .
PBN Business Development, 800.288.4901,
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