National spending on health care will rise faster than the country's gross domestic product (GDP) over the next 10 years, driven by key provisions in the Affordable Care Act, according to a new CMS report that projects spending statistics through 2020. The result will be "significantly" increased demand for prescription drugs and physician and clinical services, the report says. Healthcare spending is projected to grow at an average rate of 5.8% per year over the next decade, while GDP is projected to grow at just 4.7% per year. The result is that healthcare will grow from being 17.6% of GDP in 2010 to 19.8% of GDP in 2020, says Sean Keehan, an economist in the Office of the Actuary at CMS.

You might be wondering what will happen to your Medicare physician payments after Aug. 2 if Congress and the White House can't agree to boost the federal debt ceiling. On Aug. 2, the government is projected to exceed its debt limit of $14.3 trillion. There's been no official word from CMS, but President Obama did warn on July 12 that failure to raise the debt ceiling could result in Social Security checks, veterans' benefits and other federal obligations not being paid out as scheduled.

You had until June 30, 2011 to e-prescribe at least 10 times and report G8553 to show CMS you were e-prescribing successfully. Now that June 30 has come and gone, many of your peers who didn't meet the requirement are betting that CMS will finalize its proposed rule adding four new hardship exemptions for e-prescribing, so they can avoid the 1% payment penalty in 2012. But there is a plan B just in case the proposed hardship exemptions don't materialize.

We're deep into the pages of the proposed 2012 Medicare Physician Fee Schedule and still haven't seen light at the end of the tunnel, but one thing is clear already: weighing in at 621 pages, this is one slim tome compared to the 2011 proposed fee schedule. The 2011 edition was 1,250 pages, which means this year's version is less than half the length, or 49.6% if you want to be precise. TIP: Read our initial fee schedule findings here, if you haven't already. The biggest reason for the big difference in size has to be the health reform law, which required CMS to start turning legislation into actual rulemaking.

 CMS has finally confirmed that it will axe the clinical signature requirement rule, as we first reported in Part B News way back in February. The rule, which was set to take effect Jan. 1, 2011, would've required all clinical lab orders to be physically signed by ordering physicians. It was delayed to April 1, 2011 after taking a withering barrage of fire from advocacy groups, particularly the American Clinical Laboratory Association (ACLA).