In approving the “Tax Relief and Health Care Act of 2006” (H.R. 6111) on December 8-9, 2006, the House and Senate will prevent cuts in Medicare Physician Payments scheduled to go into effect January 1, 2007. The bill, still to be signed by President George W. Bush, has been a priority of ACOFP’s and AOA’s Washington, DC-based legislative action team since late last summer.

“ACOFP wants to thank all of our members who answered the call to contact their Congressional representatives regarding this issue,” said ACOFP President Thomas N. Told, DO, FACOFP dist. “As hard and as long as the osteopathic profession worked on this issue, it was the individual physicians contacting their Senators and Representatives who convinced Congress to stop the scheduled Medicare payment cuts. This was truly a team effort – and team win – on this issue.”

Section 101 – Physician Payment and Quality Improvement requires that the conversion factor for 2007 be the conversion factor otherwise applicable le for 2007 divided by the product of:

• 1 plus the Secretary’s estimate of the percentage increase in the MEI for 2007 (divided by 100)
• 1 plus the Secretary’s estimate of the update adjustment factor for 2007

This formula results in Medicare physician payments for 2007 being frozen at 2006 levels. These changes in the calculation for the 2007 conversion factor are not considered for the computation of the conversion factor for 2008. This means that the “baseline” assumes that the five percent cut was implemented in 2007, thus compounding the cut in 2008.

Section 101 also implements a voluntary quality reporting program for physicians applicable to Medicare payments for covered professional services tied to the reporting of claims data. This program begins July 1, 2007 and ends December 1, 2007, and will use the quality reporting measures included in the CMS Physician Voluntary Reporting Program (PVRP).

Physicians who provide services for which there are established quality measures, and satisfactorily submit quality data on those measures will be paid a single additional bonus payment amount equal to 1.5 percent of the allowed charges for covered professional services furnished during the reporting period. The bonus incentive payments will be paid from Medicare Part B, and will not be applicable to any other payment incentive programs within the Medicare program, such as payments for physicians in health professional shortage areas or Physician Scarcity Areas.

Other bill provisions include Rural Payment, Therapy Cap Extensions, Payment for Physician Administration of Part D Vaccines, a study by the Office of the Inspector General (OIG) in the Department of Health and Human Services regarding the incidence of never events for Medicare beneficiaries and the establishment of a Medicare Medical Home Demonstration Project.

More regarding this important victory on behalf of osteopathic family physicians will appear in the January 2007 issue of Osteopathic Family Physician News, and on ACOFP’s Web site, www.acofp.org.