Issued on April 20, the six recommendations and other considerations are a step in the right direction, says Pennsylvania Medical Society president Karen Rizzo, MD. Continue reading
Photo Feature ………………… 154
2015 ACMS Foundation Gala
Materia Medica ……………….. 169
SGLT2 and you: A novel target for diabetes treatment
Gregory S. Trietley, PharmD
Lucas G. Hill, PharmD, BCPS
Legal Report ………………….. 172
Beware relationships with pharmaceutical, device companies
William H. Maruca, Esq.
Practice Management …….. 174
Is your health care team warm enough?
Joe Mull, MEd
Special Report ……………….. 176
Website explains MCare refund process
Pennsylvania Medical Society
Michael A. Cassidy, Esq.
Tucker Arensberg Attorneys
After a long and tortured history, the Medicare Sustainable Growth Rate (SGR) problem has been repealed.
SGR was an integral component of the Medicare physician fee schedule, enacted in the mid 1990’s as part of the Medicare Resource Based Relative Value System (RB-RVS). This is the Medicare physician payment schedule that introduced Work Relative Value Units (WRVUs).
SGR was the “volume gatekeeper” for the physician payment system. The program was adopted as part of a long range budget which assumed both increases in physician fee schedule payments and increases in utilization over a 20 year long planning corridor, but SGR was the safety net which automatically reduced physician payments if utilization exceeded the budget projections. The implementation mechanism was the Medicare conversion factor. For those of you who are following the formula, the WRVUs, malpractice RVUs, and overhead expense RVUs were added to provide a total relative value unit sum for each service, and that unit value was multiplied by a Medicare conversion factor. The conversion factor in 2014 was $35.82. This conversion factor was the result of Congress again postponing the SGR reduction in 2014, and it was scheduled to be reduced to $28.35 in 2015, which was also postponed by Congress.