The Centers for Medicare and Medicaid Services released the Physician Fee Schedule final rule was released with several key changes for 2015, according to an AAOS Now report.
The final rule was released on Oct. 31 and key changes include:
1. A shift away from global payments with a final proposal to eliminate all 10- and 90-day global payment periods for surgical services phased-in over the next four years.
2. The hip and knee arthroplasty values adopted in 2014 were reaffirmed. The report advised the likelihood that no further reductions will be made in the "coming years" for these codes.
3. There will be penalties in 2015 for surgeons who don't meet the PQRS requirements. Those who didn't report in 2013 will receive a negative 1.5 percent payment adjustment on all Medicare reimbursements.
4. If surgeons continue not to participate, the negative percentage adjustment will go up.
5. CMS implemented the physician value-based modifier and will continue with the implementation next year. The program will be expanded in 2016 for all groups with 10 or more physicians.
6. The two PQRS measures covering osteoarthritis patient treatment were not removed from the PQRS program. AAOS will be the official "steward" of the osteoarthritis patient treatment measures.
7. Next year, the Open Payments program removes the exception for continuing medical education events and services, so physicians who receive payments for speaking at CME events will also be reported.
8. In 2016, the Physician Compare website will include all 2015 PQRS measure data reported through the group practice, registry or electronic health record. All accountable care organization performance measures will also be included
9. The proposal to publish individual reporting physician PQRS data was not finalized.
10. CMS indicated administration support for sustainable growth rate repeal permanently.