News

ISASS recently signed on to a multi-specialty letter to U.S. Senator John Barrasso, MD in support of the “Protect Continuing Physician Education and Patient Care Act” (S. 2978), which would protect the dissemination of peer and independent third-party reviewed services and products that improve patient care. The legislation clarifies a provision in the Sunshine Act (Act) that excludes “educational materials that directly benefit patients or are intended for patient use” from being reported under the Act. In interpreting and enforcing this provision, the Centers for Medicare and Medicaid Services (CMS) concluded that medical textbooks, reprints of peer-reviewed scientific journal articles and abstracts are not directly beneficial to patients and not intended for patient use, and therefore must be reported under […]

News and noteworthy information for June 2016: ISASS Convenes Payment Models Subcommittee ISASS Submits Comments to MACRA/Quality Payment Program Proposed Rule ISASS Submits Comments to 2017 Hospital Inpatient Proposed Rule CPT® Summary of Panel Actions Posted from May 2016 Meeting Recap of the AMA House of Delegates Annual Meeting Comprehensive Medicare Coverage of Minimally Invasive Sacroiliac Joint Fusion Surgery GAO Makes MedPAC Appointments   ISASS Convenes Payment Models Subcommittee In order to enhance the Society’s advocacy work, last month, ISASS convened a new subcommittee of the Coding & Reimbursement Task Force. The Payment Models Subcommittee is being spearheaded by Isador Lieberman, MD, Morgan Lorio, MD, Kern Singh, MD, and Cindy Vandenbosch and was formed to: review regulatory changes and submit […]

The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) was bipartisan legislation signed into law in April 2015 to permanently repeal the Sustainable Growth Rate (SGR), streamline physician quality reporting programs, and provide incentive payments for physician participation in alternative payment models. MACRA sunsets the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier, and the Medicare Electronic Health Record (EHR) Incentive Program in 2018 and establishes an umbrella Quality Payment Program with two new pathways for payment: 1. Merit-Based Incentive Payment System (MIPS) and 2. Advanced Alternative Payment Models (Advanced APMs). In April 2016, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule to begin the process of implementing MACRA. The proposed rule establishes a […]

On April 18, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Hospital Inpatient and Long-Term Care Hospital (LTCH) payment and policy rule. The proposed rule, which would apply to approximately 3,330 acute care hospitals and approximately 430 LTCHs, would affect discharges occurring on or after October 1, 2016. (Please note physician payment is made via the Physician Fee Schedule, which will be released in July.) The Hospital Inpatient Prospective Payment System (IPPS) pays hospitals for services provided to Medicare beneficiaries using a national base payment rate, adjusted for a number of factors that affect hospitals’ costs, including the patient’s condition and the cost of hospital labor in the hospital’s geographic area. CMS generally sets payment rates […]