CMS releases proposed 2018 physician fee schedule

At the agencies

The Centers for Medicare and Medicaid Services (CMS) released the proposed 2018 Physician Fee Schedule which includes changes to Medicare payment policies, payment rates and quality provisions for providers who treat Medicare patients in calendar year (CY) 2018. The proposed rule seeks to provide clinicians with a smooth transition to the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program (QPP); align payment between hospitals and physician practices; improve payment for office-based behavioral therapy and counseling services; and generally reduce administrative burdens for providers by modernizing the payment system for visits, care management and telehealth services.

CMS also released the 2018 Hospital Outpatient Prospective Payment System Hand Ambulatory Surgical Center Payment System proposed rule that updates 2018 rates, quality provisions and policies. This proposed rule is designed to help transform the healthcare delivery system, particularly Medicare, by focusing on patient-centered care and improving health outcomes.  Included in the proposed rule are changes to the payment rate for certain Medicare Part B drugs purchased by hospitals through the 340B program. The changes also put a two-year moratorium on the direct supervision requirement at rural hospitals and critical access hospitals.

The Office of the National Coordinator (ONC) for Health Information Technology recently released a report on improving patient access to their health records. ONC studied the medical record request process from the patient and provider perspective, ultimately concluding that a patient-centered request process would benefit both patients and health systems. The report includes suggestions for achieving streamlined, transparent and electronic records request processes, while upholding privacy protections.

From the administration

For the upcoming month, the Trump administration has funded cost-sharing reduction (CSR) payments that are paid to insurers to subsidize coverage provided to certain low-income individuals who purchased health-care coverage in the individual market through insurance exchanges.  It is unclear whether the Trump administration will continue funding CSR payments in the future.


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