Jun 10
28
MedPAC June Report Issued: “Aligning Incentives in Medicare”
The Medicare Payment Advisory Commission (MedPAC) relased their June report to Congress last week. Of note to the rehab and therapy community is Chapter Eight: “Addressing the Growth of Ancillary Services in Physician Offices.”
The chapter on ancillary services addresses outpatient therapy including physical, occupational and speech therapies. Of note is the discussion regarding the growth of ancillary services which includes eliminating outpatient therapy from the in-office ancillary exception to the Stark regulations, noting that “incident to” services declined from 30 percent share to 16% share of spending for therapy services. Also discussed is limiting the exception to practices that are clinically integrated.
The report consists of eight chapters: 2 chapters on the themes of Medicare payment accuracy and moving away from the inherent volume incentives present in Medicare fee-for-service. Three chapters highlight systemic changes to better align provider incentive with a “reformed delivery system.” The role of beneficiaries in the delivery system reform. The report also includes a chapter that discussed the role of CMS as a “value” purchaser vs. a “claims payer”.
For private practitioners working or employed in physician offices (billing under their own Medicare provider number assigned to the group), as well as those billing “incident to” under the physician number, put Chapter 8 on your summer reading list.
