The Physician Payment Review Commission: a 1990 update.

Major changes have been effected in Medicare Part B payment policy during the past year. Many of the objectives of both the PPRC and the ACS have been attained, and implementation of the reform measures will take place over the next five years. Much work remains to be done to polish the technical factors that are necessary for implementation, but current progress is on schedule. The single major difference of opinion between the PPRC and the ACS is related to the provision for a separate MVPS for surgical procedures. Clearly, better data are required before this issue can be resolved, and continued cooperation will be necessary to satisfy the congressional mandate for separate surgical and nonsurgical MVPSs. Payment for Medicaid services frequently is woefully inadequate, and the PPRC feels a strong obligation to make appropriate recommendations to Congress in order to correct these inequities. Finally, the PPRC and the ACS are on record as strongly opposing the administration's budget proposals for 1991 and instead as having supported congressional counterproposals that would result in much less severe reductions in Part B outlays.