American College of Physicians: Internal Medicine — Doctors for Adults ®


Changes in Medicare pay likely delayed until 1999

From the July/August 1997 ACP Observer, copyright © 1997 by the American College of Physicians.

At press time, legislation delaying changes in Medicare pay appeared headed for approval.

Congress had originally required HCFA to begin paying physicians based on their overhead costs, not historical payment trends, in 1998. Proposals in both the House and Senate, however, would delay any changes until 1999 and then phase them in over three or four years.

To make up for the delay, the Senate was expected to offer a "down payment" on primary care in 1998, which would transfer some reimbursement for inpatient procedures to evaluation and management services.

In addition, legislators did support creating a single conversion factor for all physicians. Currently, there are three conversion factors: one for primary care, one for surgery and one for other services. ACP says a single conversion factor would improve payment for non-surgical services and reform a system that favors surgical reimbursement.

The proposals were part of the reconciliation bills for the 1997-98 budget and were scheduled to be sent to the president this summer.

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