The wires are presently buzzing with news stories about the Centers for Medicare and Medicaid Services attempts to reign in expenses. The agency’s present agenda appears to be one of avoiding future austerity measures by creating greater cost efficiencies now.

However, not everyone is pleased with their efforts, considering that many of the proposed changes in reimbursement levels and service caps will adversely affect both patient care and healthcare providers’ profitability. The agency may be left with little choice, given the economic realities of unprecedented debt to GDP (Gross Domestic Product) levels, an intractable budget deficit, stagnant economic growth and high unemployment. Adding to the crisis is a simultaneous demographic time-bomb of an aging baby-boom generation entering retirement age, en masse.

Among the most unpopular upcoming proposals to control Medicare costs is slated to start in 2013, when the Medicare Part B therapy cap without exceptions and the 27.4% payment cut for Part B outpatient physical therapy services both go into effect. Also effective in 2013, will be a 2.3% excise tax on the first sale of medical devices, with certain exceptions. (Expect more hidden taxes in the future).

Currently, the Centers for Medicare and Medicaid Services are about to reach their final decision regarding TENS reimbursement coverage for chronic low back pain. This decision appears to have many DME providers that specialize in pain management growing concerned that any change in reimbursement for one group of patients might be the start of a chipping away at the entire TENS reimbursement program.

References:
http://www.apta.org/PTinMotion/NewsNow/2012/2/15/SGRDeal/
http://dpc.senate.gov/healthreformbill/healthbill65.pdf pg, 7