Medicare Program--Revisions to Payment Policies and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 1999

OGC-99-15: Published: Nov 17, 1998. Publicly Released: Nov 17, 1998.


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Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on payment policies and adjustments to the relative value units under the physician fee schedule for calendar year 1999. GAO noted that: (1) the rule would make several policy changes affecting Medicare Part B payments; (2) the changes that relate to physicians' services include: (a) resource-based practice expense relative value units; (b) medical direction rules for anesthesia services; and (c) payment for abnormal Pap smears; (3) the rule would also revise HCFA's payment policy for nonphysician practitioners, for outpatient rehabilitation services, and for some drugs and biologicals; (4) it further allows physicians, under certain circumstances, to opt out of Medicare and to provide covered services through private contractors and permits payment for professional consultations via interactive telecommunications systems; and (5) HCFA complied with applicable requirements in promulgating the rule.

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