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On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) finalized the Medicare Physician Fee Schedule for Calendar Year 2022 (the “Final 2022 MPFS” or the “Final Rule”). As we noted in our July article discussing the Proposed 2022 MPFS, CMS made some significant proposed changes to allow for audio-only telehealth in some limited circumstances. In addition, the agency also proposed to enable remote “direct supervision,” which would allow practitioners to supervise clinical staff billing incident to their services as long as they could be available by audio/video communication as necessary.
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The Centers for Medicare and Medicaid Services (CMS) issued its Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule (IFR) on November 4, 2021, the same day the Department of Labor’s Occupational Safety and Health Administration (OSHA) issued its COVID-19 Vaccination and Testing Emergency Temporary Standard (ETS). The IFR and ETS complement each other, with both aimed at furthering the Biden Administration’s goal of vaccinating the entire United States healthcare workforce to ensure capacity to serve local and national healthcare needs, the safety of the workforce and patients, and to reduce the risk of continued COVID-19 transmission. Both rules are effective November 5, 2021.
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On December 1, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released its Final Medicare Physician Fee Schedule for 2021 (the “Final 2021 MPFS”), revising payment policies for services provided to Medicare beneficiaries by medical practitioners. These policies will take effect on January 1, 2021. Read on for insights from Team NGL.
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On Monday, August 3, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Medicare Physician Fee Schedule Proposed Rule (the “2021 Proposed Rule”). In the healthcare industry, the Medicare Physician Fee Schedule or “MPFS” is arguably the most prominent force shaping the industry on an ongoing basis. Each year, CMS releases a Proposed Rule mid-summer to give stakeholders a first look at what is potentially to come for the following year. Stakeholders have an opportunity to comment on those proposals, CMS reads the comments it receives, and then based on those comments CMS updates its proposals and releases a Final Rule.
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Nixon Law Group’s Managing Partner, Carrie Nixon, was quoted in an article appearing in Modern Healthcare discussing the Senate HELP Committee hearing on telehealth that took place on June 17, 2020. The article notes general consensus among Committee members on two areas set forth as priorities by the Committee’s Chair, including 1) making permanent the elimination of the originating site and geographic restrictions for Medicare reimbursement of telehealth visits; and 2) maintaining and potentially expanding the list of services that may be provided by telehealth under Medicare, along with the list of types of healthcare providers eligible to provide these services to Medicare beneficiaries.
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The Center for Medicare and Medicaid Services (“CMS”) has issued a second Interim Final Rule (“IFR2”) that includes additional expansions and clarifications relating to the provision and reimbursement of telehealth, remote patient monitoring, and telephone services during the COVID-19 Public Health Emergency (“PHE”). While these expansions are another step forward for the adoption of digital technologies and services in healthcare, there are additional changes needed in the near-term, as detailed in the summary below.
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Medical providers across the spectrum have endured a significant hit to revenues as a result of the COVID-19 public health emergency (PHE). MGMA’s recent report, “COVID-19 Financial Impoact on Medical Practices”, indicates that nearly 100% of providers have seen a negative revenue impact, with an average decrease in revenue of 55%. To offset some of those losses, the CARES Act allocated a $50 billion “general allocation” to support the sustainability of these providers.
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On January 21, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized a decision (under National Coverage Determination (NCD) 30.3.3) to cover acupuncture for Medicare patients, specifically those with chronic low back pain (cLBP).
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On July 29, 2019, the Center for Medicare and Medicaid Services (“CMS”) released its proposed rule for the 2020 Medicare Physician Fee Schedule (the “2020 MPFS”).
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In April, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced a new set of payment models meant to allow primary care providers deliver better care at a lower cost to their patients by removing unneccessary administrative and adjust payouts from procedures to outcomes.
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We’ve gathering some resources for NLG Chiropractice clients. Learn about updated medicare billing references and covered services and policies from the linked articles below.
Contact us if you have any questions!
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The 2018 Medicare Physician Fee Schedule Final Rule (“2018 MPFS” or “Final Rule”) went into effect on January 1. Marked by new additions to the Telehealth codes and the un-bundling of Remote Patient Monitoring code CPT 99091, the 2018 MPFS provides plenty of opportunities for providers to grow their practice through digital medicine. This article outlines key changes to the new Rule.
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Have you decided which MACRA participation option your practice will choose in the 2017 transition year? What you choose now (and how you implement) determines your payment adjustment for Medicare Part B billings in 2019 and beyond. In the second blog post of our MACRA series, we talk about the Merit Based Incentive Payment System (MIPS), and what it means for physicians.
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The Final MACRA Rule relaxed the more stringent proposed requirements for 2017, so whether you choose to dip your toe in the water or take the full-on MACRA plunge, now is the time to get MACRA-ready and avoid reimbursement penalties. What does MACRA mean for your practice? That's a question we can help answer.
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The biggest takeaway from this proposed Rule? Physicians should start planning for this change IMMEDIATELY to best position their practice for financial sustainability. This rule establishes the new Quality Payment Program (QPP) framework, which consists of two new pathways for provider evaluation and payment—the Merit-based Incentive Payment System (MIPS) and participation in Advanced Alternative Payment Models (APMs). The QPP stems from the changes passed as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), passed in April of last year. Participation in one of the QPP pathways will form the new basis for the level of payment for services Medicare Part B providers will receive. CMS will begin collecting data beginning in 2017. They will analyze the data for one year, and then use the data to adjust Medicare payments for eligible providers starting January 1, 2019.
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