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19.02.2013 Views

CMS-1403-FC misvalued codes by a workgroup of the AMA RUC, as well as our review and decisions regarding the AMA RUC workgroup’s recommendations. The AMA RUC submitted several recommendations for misvalued codes in May 2008 and the remainder of their recommendations for misvalued codes in October 2008. Due to the timing of the May 2008 AMA RUC recommendations, it was impracticable for CMS to adequately evaluate and solicit public comment prior to this final rule with comment period. We believe it is in the public interest to implement the revised RVUs for the 61 codes that were identified as misvalued, and that have been reviewed and re-evaluated by the AMA RUC workgroup, on an interim final basis for CY 2009. These revisions will establish a more appropriate payment for these services, some of which changed significantly since they were originally valued. The revisions of RVUs for these codes will establish a more appropriate payment that better corresponds to the relative resources associated with furnishing these services. A delay in implementing revised values for these misvalued codes would not only perpetuate the known misvaluation for these services, it would also perpetuate a distortion in the payment for other services under the PFS. Implementing the changes now allows for a more equitable distribution of payments across all PFS 1004

CMS-1403-FC services. We believe a delay in implementation of these revisions would be contrary to the public interest, particularly since the AMA RUC process allows for an assessment of the valuation of these services by the medical community prior to the AMA RUC’s recommendation to CMS. For the reasons described above, we find good cause to waive notice and comment procedures with respect to the misvalued codes identified in Table 26, and to revise RVUs for these codes on an interim final basis. We are providing a 60-day public comment period. Sections III. and VI.B. this final rule with comment period also address certain provisions of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Pub. L. 110-275) which became law after publication of the CY 2009 PFS proposed rule. Except as noted further below, we consider these provisions to be self-implementing. We are revising our policies and regulations as described in this final rule with comment period in order to conform them to the statutory amendments. Because these revisions are in accordance with explicit statutory amendments, we find that notice and comment procedures are unnecessary for their implementation. Therefore, we find good cause to waive notice and comment procedures with respect to the 1005

<strong>CMS</strong>-1403-FC<br />

services. We believe a delay in implementation of these<br />

revisions would be contrary to the public interest,<br />

particularly since the AMA RUC process allows for an<br />

assessment of the valuation of these services by the<br />

medical community prior to the AMA RUC’s recommendation to<br />

<strong>CMS</strong>.<br />

For the reasons described above, we find good cause to<br />

waive notice and comment procedures with respect to the<br />

misvalued codes identified in Table 26, and to revise RVUs<br />

for these codes on an interim final basis. We are<br />

providing a 60-day public comment period.<br />

Sections III. and VI.B. this final rule with comment<br />

period also address certain provisions of the Medicare<br />

Improvements for Patients and Providers Act of 2008 (MIPPA)<br />

(Pub. L. 110-275) which became law after publication of the<br />

CY 2009 PFS proposed rule. Except as noted further below,<br />

we consider these provisions to be self-implementing. We<br />

are revising our policies and regulations as described in<br />

this final rule with comment period in order to conform<br />

them to the statutory amendments. Because these revisions<br />

are in accordance with explicit statutory amendments, we<br />

find that notice and comment procedures are unnecessary for<br />

their implementation. Therefore, we find good cause to<br />

waive notice and comment procedures with respect to the<br />

1005

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