June 25, 2019

CMS Issues a Proposed Rule to Update E-prescribing Standards To Reduce Provider Burden and Expedite Patient Access To Needed Medications

On June 17, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would improve patients’ access to necessary medications by updating the prior authorization process for Medicare Part D, the program that provides coverage for prescription drugs that beneficiaries pick up at a pharmacy counter. The prior authorization process requires that providers supply additional clinical information to verify that the medication can be covered under the Medicare Part D benefit. The process is intended to promote better clinical decision-making and help ensure that patients receive medically necessary prescription drugs. The proposed rule would update the Part D e-prescribing program by adopting standards that ensure secure transmissions and expedite prior authorizations. Under the proposed changes, clinicians would […]
June 25, 2019

CMS Seeks Public Input on Patients over Paperwork Initiative to Further Reduce Administrative, Regulatory Burden to Lower Healthcare Costs

On June 6, CMS issued a Request for Information (RFI) seeking new ideas from the public on how to continue the progress of the Patients over Paperwork initiative. Since launching in fall 2017, Patients over Paperwork has streamlined regulations to significantly cut the “red tape” that weighs down our healthcare system and takes clinicians away from their primary mission—caring for patients. CMS estimates that since January 2019, the healthcare system will save an estimated 40 million hours and $5.7 billion through 2021 from reduced administrative burdens. These estimated savings come from both final and proposed rules. This RFI provides an opportunity for stakeholders to share new ideas not conveyed during the first Patients over Paperwork RFI in 2017 and continue […]
June 25, 2019

AMA House of Delegates Meets and Reviews High Priority Health Policy and Physician Practice Issues

ISASS and other Physician Specialty Societies met in Chicago from June 8-12, as part of the annual AMA House of Delegates convention.  The AMA House of Delegates is the AMA’s policy-making body and consists of specialty and state societies and other physician stakeholders. The more than 500 voting delegates selected by their member organizations are charged with establishing broad policy on health, medical, professional and AMA governance issues. Members of the House of Delegates include state medical associations, the five federal services, national medical specialty societies and professional interest medical associations, sections and groups. ISASS is considered a national medical specialty society in the House of Delegates and participates in the Specialty and Service Society (SSS) Caucus, the largest caucus […]
June 25, 2019

ISASS Urges Changes to NCCI Edits for Spine Surgery

In a letter dated June 11,  ISASS provided additional input and reiterated its request from April 18,  for CMS to consider changes to a set of National Correct Coding Initiative (NCCI) edits for CPT codes 22842, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure), 22843, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure), 22844, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for […]