White House Plan Calls for Cuts to Specialists

Equally important, he said, is that increasing the payments sends the message to medical students that primary care is a viable field and that they don't have to go into subspecialties to earn a living.

Conversely, subspecialists would lose out under the schedule proposal, experiencing either cuts or only small increases.

The fee schedule proposal also includes policy changes related to imaging. The proposed rule would cut payments for certain high-cost imaging services by assuming that imaging equipment priced at more than $1 million is used 90% of the time, compared with the current assumption of use at 50%.

The proposed change is based on studies from the Medicare Payment Advisory Commission (MedPAC) showing that the use of high-cost imaging equipment is higher than previously thought. MedPAC found that in certain markets, MRIs were being used an average of about 46 hours a week, or 92% of a 50-hour workweek. As written, the rule would not affect lower-cost imaging services such as bone density testing and ultrasound. The agency said it will continue to examine the data for equipment valued at less than $1 million but is not proposing a change at this time. The CMS noted that it does not expect the imaging proposal to create access issues in rural areas.

The cut takes money away from specialists to provide additional compensation to primary care physicians.

Source DR. LAKHANPAL

This Month's Talk Back Question

What's your view of the proposal to cut Medicare pay for subspecialty physicians?