AHA asks HCFA to delay physician fee start-up

In a December letter, the American Hospital Association (AHA) in Washington, DC, asked the Health Care Financing Administration (HCFA) in Baltimore to delay the effective date for payment to hospitals under the physician fee schedule. The date was slated for Jan. 1, 1999.

The schedule was published in the Federal Register on Nov. 2, 1998.1

"Switching from payment on a reasonable cost basis to the fee schedule will require major coding and billing system changes, and to date, HCFA has failed to notify hospitals of these requirements," wrote Rick Pollack, AHA’s executive vice president of government and public affairs.

"Fiscal intermediaries, generally unfamiliar with the procedure and revenue codes associated with the fee schedule, have not provided hospitals with lists of codes and payments associated with these [outpatient] therapies."

Other delays

HCFA has already announced that system modifications required for outpatient prospective, also scheduled for a Jan. 1, 1999, start-up date, will be delayed.

Since the time frame for changes required for that conversion were thought to correspond to system changes required for the fee schedule, Pollack asked for the payment to hospitals for outpatient therapies be delayed as well.


1. 63 Fed Reg 58,813 (Nov. 2, 1998).