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GAO urges Medicare-payment leveling


A new Government Accountability Office (GAO) report says that rapidly increasing consolidation of hospitals and physician practices shows the urgent need for Medicare payment reform.

Medscape notes that the problem is “the differential between the payments  to physicians for evaluation and management (E&M) services when they deliver them in a hospital outpatient department (HOPD) and when they perform them in private practices. In 2014, the GAO found Medicare’s payment rate for E&M office visits ranged from $58 to $86 higher when they were performed in an HOPD compared with in an independent physician office.”
The GAO  has recommended that Congress pass legislation to level the playing field between the payments for E&M visits in HOPDs and private practices; CMS does not have statutory authority to do so on its own.

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