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CMS-1403-FC
and improve the quality and value of care provided to
Medicare beneficiaries.
We do not believe that beneficiaries will experience
drug access issues as a result of the changes with respect
to Part B drugs and discontinuation of payment for
preadministration services associated with IVIG.
As explained in more detail subsequently in this
section, the regulatory provisions may affect beneficiary
liability in some cases. Most changes aggregate in
beneficiary liability due to a particular provision would
be a function of the coinsurance (20 percent if applicable
for the particular provision after the beneficiary has met
the deductible). Beneficiary liability would also be
impacted by the effect of the aggregate cost (savings) of
the provision on the standard calculation of the Medicare
Part B premium rate (generally 25 percent of the
provision's cost or savings). In 2009, total cost sharing
(coinsurance and deductible) per Part B enrollee associated
with PFS services is estimated to be $468. In addition,
the portion of the 2009 standard monthly Part B premium
attributable to PFS services is estimated to be $40.10.
To illustrate this point, as shown in Table 47, the
2008 national payment amount in the nonfacility setting for
CPT code 99203 (Office/outpatient visit, new), is $91.03
1090