The Fifth Circuit Court of Appeals raised concerns Friday over a new policy from the Centers for Medicare and Medicaid Services (CMS) that could cost four Texas anesthesia practices up to $4 million in reduced reimbursements. U.S. Circuit Judge Cory T. Wilson questioned the government’s justification for including nurse practitioners working in anesthesia practices as primary care providers under CMS’ merit-based incentive payment system (MIPS), which holds primary care clinicians accountable for their patients’ total Medicare costs.
During oral arguments, Judge Wilson expressed skepticism about the policy’s logic. He noted that while the government attributes costs to nurse practitioners, their role in a specialty practice like anesthesia shouldn’t be counted in the same way as those in primary care. “It does seem incongruous to me that you’re attributing costs to nurse practitioners and physician assistants in a specialty practice that’s otherwise excluded from attribution of cost,” Wilson said. “Why? How do you do that?”
