On July 12, 2007, CMS published in the Federal Register its Notice of Proposed Rule Making (NPRM) regarding the 2008 Medicare Physician Fee Schedule (MPFS) . In this NPRM, CMS proposed, among other things, the following potentially good news:

The work component of anesthesia services will increase by 32%.
Payment for preadmission-related services for intravenous infusion of immunoglobulin (IVIG) will continue.
Voluntary quality reporting bonus payments will be extended into 2008.
Neurobehavioral status exams will be added to the list of telemedicine services.

In addition, this NPRM announced the following potentially neutral news:

Rules regarding services furnished in a Comprehensive Outpatient Rehabilitation Facilities (CORF) will be updated.
Individuals furnishing physical and occupational therapy to Medicare patients will be required to meet new licensing, registration, certification, and/or educational requirements.
The MPFS Geographic Practice Cost Indices (GPCI) will be updated.
Physician payment localities will be revised.
The methodology for determining the average sales price (ASP) for Part B drugs would be revised by defining bundled arrangements.
The requirements under the competitive acquisition program (CAP) for Part B drugs for confirming drug administration will be modified.

Finally, CMS suggested the following potentially not-so-good news:

The technical component of ophthalmologic imaging procedures performed in freestanding imaging centers will be added to the list of procedures that are subject to the hospital outpatient prospective payment system (OPPS) caps.
Claims for drugs used to treat anemia secondary to anticancer treatment will require reporting of hemoglobin or hematocrit data.
Number of new physician self-referral provisions are introduced, including one involving services rendered under an arrangement with a hospital.
Enrollment standards for Independent Diagnostic Testing Facilities (IDTFs) will be modified.
The exemption for computer-generated faxes from the e-prescribing standards will be eliminated.

Overall, physicians and other Part B suppliers paid through the MPFS are expected to receive approximately 9.9 percent less in 2008 compared to this year. More importantly, this NPRM may require hospitals and other facilities to submit comments to CMS in order to address adverse consequences and preserve future appeal rights. CMS is accepting comments through August 31, 2007.

Ober|Kaler's Health Law Group represents a broad array of health care clients in various areas including coverage and reimbursement, fraud and abuse, licensing and certification, compliance, and transactional matters. The Payment Group specifically focuses on Medicare and Medicaid payment issues for health care professionals and entities, providing advice and representation concerning reimbursement and related compliance matters important to health care facilities and providers. Our attorneys, many of whom were formerly with the government, have extensive experience in all manner of Medicare issues including PRRB and claims appeals, regulatory compliance, certification and enrollment, Medicaid reimbursement, and developing and implementing corporate compliance plans.

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