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医疗保险计划;2004日历年医疗保险药品支付和医师费用表支付的变更。有意见征求期的暂行最终规则。

Medicare program; changes to Medicare payment for drugs and physician fee schedule payments for calendar year 2004. Interim final rule with comment period.

出版信息

Fed Regist. 2004 Jan 7;69(4):1083-267.

PMID:14968797
Abstract

This interim final rule implements the provisions of the Medicare Prescription Drug, Improvement, and Modernization Act (MPDIMA) of 2003, Pub. L. 108-173, which are applicable in 2004 to Medicare payment for covered drugs and physician fee schedule services. These provisions revise the current payment methodology for Part B covered drugs and biologicals that are not paid on a cost or prospective payment basis; make changes to Medicare payment for furnishing or administering drugs and biologicals; revise the geographic practice cost indices and change the physician fee schedule conversion factor. The 2004 physician fee schedule conversion factor will be $37.3374. The 2004 national anesthesia conversion factor (prior to making adjustment for the geographic practice cost indices) will be $17.4969. The information contained in this final rule related to payment under the physician fee schedule supercedes the information contained in the November 7, 2003, final rule to the extent that the two are inconsistent. All other provisions of the November 7, 2003, final rule are unchanged unless otherwise noted. This rule also extends the "opt-out" provisions of 1802(b)(5)(3) of the Social Security Act to dentists, podiatrists, and optometrists.

摘要

本暂行最终规则实施了2003年《医疗保险处方药、改进与现代化法案》(MPDIMA),即公法第108 - 173号的相关规定,这些规定于2004年适用于医疗保险对涵盖药品和医师费用表服务的支付。这些规定修订了目前对B部分涵盖的非按成本或预期支付方式支付的药品和生物制品的支付方法;对提供或管理药品和生物制品的医疗保险支付进行了更改;修订了地理执业成本指数并更改了医师费用表换算因子。2004年医师费用表换算因子将为37.3374美元。2004年全国麻醉换算因子(在对地理执业成本指数进行调整之前)将为17.4969美元。本最终规则中包含的与医师费用表支付相关的信息在两者不一致的范围内取代了2003年11月7日最终规则中包含的信息。2003年11月7日最终规则的所有其他规定均保持不变,除非另有说明。本规则还将《社会保障法》第1802(b)(5)(3)条的“选择退出”规定扩展至牙医、足病医生和验光师。

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