2014 Physician Fee Schedule Final Rule Issued; Anesthesiology Receives 1 Percent Increase to Allowed Charges, MAV Process Maintained for PQRS

On November 27, the Centers for Medicare & Medicaid Services (CMS) released the 1,369-page Calendar Year 2014 Physician Fee Schedule (MPFS) final rule.  Absent Congressional intervention, the rule sets forward a process to reduce payments to the conversion factor by 20 percent in 2014 as called for under the Medicare Sustainable Growth Rate.   

ASA is pleased that the final rule implemented changes recommended by the Technical Advisory Panel (TAP) to the Medicare Economic Index (MEI), a medical practice inflationary mechanism.  These changes include a one percent increase to allowed charges for anesthesiology. The changes were brought about to better align resources required to provide care between the work and practice expense components of a service and will benefit work-intense specialties like anesthesiology.  While anesthesiology received a one percent increase to allowed charges, many other specialties saw no increase or a negative impact. 

CMS increased the number of required measures for satisfactory reporting in the 2014 Physician Quality Reporting System (PQRS) from three to nine and increased the number of required National Quality Strategy (NQS) domains from one to three. However, for physicians unable to meet this new threshold due to a lack of applicable measures or domains, CMS heeded the advice of ASA and other stakeholders by maintaining the claims-based Measures Applicability Validation (MAV) process and extending the MAV to include registry reporting as well.

REVISED: ASA has clarified with CMS that eligible professionals reporting fewer than nine measures covering less than three NQS domains may still qualify for an incentive payment if they successfully complete the MAV process. The 2016 Value-Based Payment Modifier (VBPM) is based on participation in the 2014 PQRS. Since the 2016 VBPM will apply to all groups of 10 or more eligible professionals, it is extremely important that members participate in the 2014 PQRS. 

ASA is currently reviewing the full 1,369 page final rule and its impact on anesthesiologists.

Review the full 1369 page final rule.
Review ASA's comments on the proposed rule.
Review the rule's PQRS Participation Table. 
Review the CMS Fact Sheet on Policy Changes and Payment Changes.
Review the CMS Fact Sheet on Changes for the CY 2014 Physician Quality Reporting Programs and the Value-Based Payment Modifier.  
Learn more about the PQRS.
Learn more about the VBPM.