Medicare Physician Payments: Medical Settings and Safety of Endoscopic Procedures

摘要

Section 411 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) directed us to examine the practice of providing physician services that are ordinarily performed in health care facilitiessuch as gastroenterological and urological endoscopic proceduresin physicians offices. We were directed to (1) review safety evidence regarding medical settings, (2) assess whether the practice expense site-of-service payment differential has served as an incentive for physicians to perform such procedures in their offices rather than in other medical settings, and (3) assess whether access to care by Medicare beneficiaries would be affected if these procedures were no longer reimbursed by Medicare when conducted in physicians offices. For our study, we selected 12 gastroenterological and 8 urological procedures that are ordinarily performed in health care facilities for Medicare beneficiaries.