August 5, 2015

CMS Releases Proposed 2016 Physician Fee Schedule Rule

General Overview of the Proposed 2016 Physician Fee Schedule The Social Security Act (the Act) requires the Centers for Medicare & Medicaid Services (CMS) to establish payments under the Physician Fee Schedule (PFS) based on national uniform relative value units (RVUs) that account for the relative resources used in providing a service. The Act requires that RVUs be established for three categories of resources: work, practice expense and malpractice expense. The Act also requires CMS to establish by regulation each year’s payment amounts for all physicians’ services paid under the PFS, incorporating geographic adjustments to reflect the variations in the costs of furnishing services in different geographic areas. There are over 1 million physicians, other practitioners, and medical suppliers that […]
June 22, 2015

ISASS Submits Letter to WPS Medicare in Opposition to Proposed Negative LCD

On April 1, 2015, Wisconsin Physicians Service Insurance Corporation (WPS Medicare) issued a proposed non-coverage Local Coverage Determination (LCD) for minimally invasive sacroiliac joint fusion (MIS SIJ fusion). WPS Medicare is the Medicare Administrative Contractor (MAC) covering Michigan, Indiana, Iowa, Nebraska, Missouri and Kansas. ISASS drafted a comment letter urging WPS Medicare to review the ISASS coverage criteria on the procedure and all relevant literature in order to develop a comprehensive coverage policy. The ISASS comment letter was submitted on June 17 and ISASS subsequently sent an advocacy action alert email to members in the WPS Medicare jurisdiction urging them to send individual letters to WPS voicing their concerns. The comment period ends on June 27 and WPS Medicare should issue […]
June 17, 2015

Advocacy Alert: WPS Medicare Draft LCD

Action Alert! Attention ISASS Members within WPS Medicare Jurisdiction: Michigan, Indiana, Iowa, Nebraska, Missouri and Kansas WPS Medicare – Proposed non-coverage decision – DL35994 – Percutaneous minimally invasive fusion/stabilization of the sacroiliac joint for the treatment of back pain On April 1, 2015, Wisconsin Physicians Service Insurance Corporation (WPS Medicare) issued a proposed non-coverage determination for minimally invasive sacroiliac joint fusion (MIS SIJ fusion). According to its draft Local Coverage Determination (LCD), WPS Medicare believes that the SI joint is a controversial source of primary low back pain and cannot be effectively isolated as a pain source. Additionally, WPS Medicare states that fusion/stabilization of the SI joint for the treatment of back pain presumed to originate from the SI joint is […]
June 12, 2015

ISASS Participates in 2015 Annual AMA House of Delegates Meeting

  ISASS attended the American Medical Association (AMA) annual meeting June 6-10 in Chicago. After a three-year process to obtain a voting seat, ISASS became a voting member of the AMA’s House of Delegates (HOD) in 2014. The HOD is the legislative and policy-making body of the AMA and includes over 500 voting delegates selected by their member organizations to establish broad policy on health, medical, professional and AMA governance issues. Members of the HOD include state medical associations, the five federal services (US Air Force, US Army, US Navy, US Department of Veterans Affairs and US Public Health Service), national medical specialty societies and professional interest medical associations, sections and groups. ISASS is considered a national medical specialty society […]