decisionhealth Newsletters, Part B News - 2007 Issue 8 (August)
GPCI: GAO urges CMS to standardize locality definition; GAO to CMS: Redraw payment localities
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Article Overview
This article discusses a Government Accountability Office review of CMS’s geographic payment locality methodology for physician reimbursement. It explains why the issue matters for Medicare payment accuracy, what broad types of alternative locality approaches GAO examined, and how CMS responded to recommendations about standardizing and periodically revising locality definitions. The piece is relevant to physician payment policy, Medicare administration, and coding/reimbursement professionals who track geographic adjustment methods.
Why This Topic Matters
Geographic payment localities can materially affect Medicare physician reimbursement across regions. Understanding proposed changes to locality definitions and GPCI methodology helps stakeholders assess payment accuracy, regional variation, and policy impacts.
What You Will Learn
- How GAO reviewed CMS’s geographic payment locality methodology
- Why locality definitions can affect physician payment accuracy
- What broad alternative approaches GAO considered for revising payment localities
- How CMS responded to recommendations about standardization and periodic review
- Why geographic practice cost indexes matter to Medicare physician payment policy
Who Should Read This
- Medical coders
- Coding managers
- Revenue cycle professionals
- Physician practice administrators
- Healthcare policy analysts
- Compliance staff
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