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MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss various Medicare payment issues.

Among the issues discussed at MedPAC’s April meeting were:

  • Medicare skilled nursing facility value-based purchased program.
  • Medicare alternative payment models (APMs).
  • Medicare Advantage benchmark policy.
  • Medicare indirect medical education (Medicare IME) payments.
  • Medicare vaccine coverage and payments.
  • Medicare payment for prescription drugs prescribed on an outpatient basis.
  • Private equity and Medicare.
  • Medicare clinical laboratory fee schedule.

MedPAC is an independent congressional agency that advises Congress on issues involving Medicare.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.  Because so many patients of private safety-net hospitals are insured by Medicare, MedPAC’s deliberations are especially important to those hospitals.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.

CMS Proposes Changes in Medicare Physician Payments

The Centers for Medicare & Medicaid Services has published a proposed regulation that it says

…proposed historic changes that would increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare. The proposed rules would fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their electronic health records (EHRs) to document clinically meaningful information instead of information that is only for billing purposes.

Among the policy changes offered in the proposed 1743-page regulation governing Medicare physician payments are:

  • a 0.25 percent increase in physician fees;
  • changes in how physicians and other clinicians document and bill for their services;
  • new provisions governing Medicare payments for telehealth services, including those offered by phone;
  • reductions in the cost of new prescription drugs and reduced payments to physicians for administering drugs;
  • changes in the Medicare quality program;
  • the continuation of the current site-neutral payment policy for outpatient services; and
  • changes in the MACRA (Medicare Access and CHIP Reauthorization Act of 2015) program.

Stakeholders have until September 10 to submit formal comments about the CMS proposals.

Learn more about these and other changes presented in the proposed regulation by consulting this CMS news release, this CMS fact sheet, and the proposed regulation itself.