Advocacy News

July 25, 2017

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House Passes Bipartisan Bill to Better Equip Medical Professionals

Bonefied News

CMS Releases Physician Fee Schedule, Changes for Hospital Outpatient, Ambulatory Surgical Center Payment Systems

House Committee Approves Veteran Legislation

Health Subcommittee Examines Medicare Legislation

Quality Payment Program Updates

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New Resident PAC
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ICYMI: 5 Ways for Healthcare Providers to Get Ready for New Medicare Cards

PAC Participation Leader Board by State

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CMS Releases Physician Fee Schedule, Changes for Hospital Outpatient, Ambulatory Surgical Center Payment Systems

The Centers for Medicare & Medicaid Services (CMS) recently issued two important proposed rules. First, the Physician Fee Schedule would update Medicare payment and policies for doctors and other clinicians who treat Medicare patients in calendar year (CY) 2018. Another proposed rule would updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. According to CMS, the proposed rules are a few of several Medicare payment rules for CY 2018 that “reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of care.” AAOS will be submitting comments on both proposed rules.

“Doctors want to spend less time on burdensome regulations from Washington, D.C., and more time with their patients,” said CMS Administrator Seema Verma. “We believe this new approach will improve quality of care and result in better health outcomes. CMS is committed to giving providers and beneficiaries alike more flexibility and choice in healthcare and is eager to hear comments on our proposed rule. We look forward to addressing the feedback we receive in our final rule later this year.”

The Physician Fee Schedule is updated annually to include changes to payment policies, payment rates, and quality provisions for services furnished to Medicare beneficiaries. In addition to physicians, a variety of medical professionals, including nurse practitioners, physician assistants, and physical therapists, as well as radiation therapy centers and independent diagnostic testing facilities, are paid under the Physician Fee Schedule. According to CMS, this proposed rule would provide greater potential for payment system modernization and seeks public comment on reducing administrative burdens for providing patient care, including visits, care management, and telehealth services. The rule takes steps to better align incentives and provide clinicians with a smoother transition to the new Merit-based Incentive Payment System under the Quality Payment Program (QPP). The rule encourages fairer competition between hospitals and physician practices by promoting greater payment alignment, and it would improve the payment for office-based behavioral health services that are often the therapy and counseling services used to treat opioid addiction and other substance use disorders. In addition, the proposed rule makes additional proposals to implement the Center for Medicare and Medicaid Innovation’s Medicare Diabetes Prevention Program expanded model starting in 2018.

For a fact sheet on the Physician Fee Schedule proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-07-13-2.html.

The proposed rule (CMS-1676-P) and the Request for Information can be downloaded from the Federal Register at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-14639.pdf.

The OPPS and ASC payment system are updated annually to include changes to payment policies, payment rates, and quality provisions for those Medicare patients who receive care at hospital outpatient departments or receive care at surgical centers. This proposed rule also includes a provision that would alleviate some of the burdens rural hospitals experience in recruiting physicians by placing a two-year moratorium on the direct supervision requirement currently in place at rural hospitals and critical access hospitals.

In addition, CMS is releasing within the proposed rule a Request for Information to welcome continued feedback on flexibilities and efficiencies in the Medicare program. CMS is committed to maintaining flexibility and efficiency throughout Medicare. Through transparency, flexibility, program simplification, and innovation, we aim to improve the Medicare program and promote the availability of high-value and efficiently-provided care for its beneficiaries.

For a fact sheet on the OPPS and ASC proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-07-13.html.

The proposed rule (CMS-1678-P) and the Request for Information can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection