Specialists Cry Foul on Medicare Reimbursement Cuts

When the Centers for Medicare and Medicaid published its reimbursement rates for Fiscal 2013, one group of specialized medical professionals has complained it was caught unawares that reimbursements for tests would be cut by as much as 50 percent.

As Medicare reimbursements under the Patient Protection and Affordable Care Act are shifted and reduced, expect to see more professional groups defending their specialty against cuts. Neurologists have become the first speciality to protest, complaining to regulators that cuts in reimbursements for diagnostic tests, part of the Affordable Care Act’s shift of focus and revenues to primary care physicians, will cripple the profession.

Medicare estimates that reimbursements for neurology services will drop by 7 percent this fiscal year. “According to CMS, the reduction is a result of the potentially misvalued code initiative, which impacted EMG and nerve conduction tests,” according to a statement by the American Academy of Neurology (AAN).

Dr. Bruce Sigsbee, president of the AAN, told the Boston Globe, “This loss of revenue is devastating,” not only to neurologists, but to the entire specialty.

The cuts caught the neurology community by surprise, according to the AAN. The recommendation to cut the reimbursement rate originated with the American Medical Association’s Specialty Society Relative Value Scale Update Committee, known as RUC. Even though the academy of neurologists “actively participates” in RUC, “there was no way for the Academy to know before the final rule was published that CMS would make such drastic reductions,” according to an AAN statement. “Physicians who provide nerve conduction and needle EMG services will face dramatic cuts of more than 50 percent for some services starting January 1, 2013,” according to AAN.

“Although the ruling goes into effect in January 2013, the AAN is looking at every possible avenue to alter the values in the next year,” writes AAN. “The Academy is working with the American Association of Neuromuscular & Electrodiagnostic Medicine and the American Academy of Physical Medicine and Rehabilitation to propose higher values for these services or a phase in of the cuts, and will continue to work with those societies to advocate for better reimbursement whether it be at CMS or in the halls of Congress.”