Medicare Announces Major Payment Policy Recommendations for 2019

Jul 26, 2018 at 04:30 pm by Staff


Fraser Cobbe

Orange County Medical Society

Seminole County Medical Society

Over the past several weeks, the Centers for Medicare and Medicaid Services (CMS) have announced significant Medicare payment reform proposals that, if approved, could transform reimbursement policy in the Medicare program. While organized medicine continues to review the proposals to determine the ultimate impact on our physician members, there is no doubt that these proposals are bold and will have a lasting impact on the Medicare program.

CMS has rolled out these initiatives in a series of announcements highlighting their efforts to modernize Medicare, reduce paperwork, and empower patients. CMS is soliciting input from all stakeholders concerning these recommendations during their official comment periods.

Some of the highlights include:

* Site neutral payment methodologies for clinic visits.

* Increasing the number of procedures that Medicare will cover in the ASC setting.

* Adopting payment policies to make sure reimbursement for devices used in the ASC setting parallels compensation for the same devices used in hospital outpatient departments.

* Stabilizing the differential between ASC payment rates and hospital outpatient department payment rates.

* Reducing the number of E&M codes and averaging out reimbursement.

* Expanding telehealth services and virtual check-ins.

* Removing MIPS process-based quality measures that clinicians have said are low-value.

* Overhauling the MIPS "Promoting Interoperability" performance category to support greater EHR interoperability and patient access to their health information.

Our organization will continue to distribute information on these proposals to our members. We would encourage all physicians to carefully review the proposals and consider how these recommendations would impact their practice. Now is the time to reach out to CMS and make your voice heard on these proposals.

The pace of change in medicine is unrelenting and our organizations are here to represent your interests and keep you updated on the latest developments.