Policy Statements

CMS Announces a Model for Rural Health Care Access and Transformation On September 16, 2020, the CMS Innovation Center announced the Community Health Access and Rural Transformation (CHART) Model. As part of that rural transformation, including transforming a system built on fee-for-service and volume to one based on value, CMS is testing the CHART Model. Through the Model, CMS is directly providing a pool of $75 million in upfront seed funding, with 15 rural communities applying for up to $5 million to develop local transformation plans. With this upfront seed funding, CMS is also providing regulatory and operational flexibility for updated service delivery models as well as changing how participating hospitals in these communities are paid, from a system based […]

Blue Cross Plans Announce Settlement in Antitrust Lawsuit It was announced on September 24, 2020, that the nation’s Blue Cross plans have reached a tentative $2.7 billion settlement in a federal lawsuit filed by their customers that accuses the group of engaging in a conspiracy to thwart competition among the individual companies, according to two people with knowledge of the discussions. The settlement, which was first reported by The Wall Street Journal, would need to be agreed to by each of the three dozen Blue Cross insurers that make up the trade group, the Blue Cross Blue Shield Association. Judge R. David Proctor of the U.S. District Court for the Northern District of Alabama, who is overseeing the case in that […]

New CPT Codes for Reporting Medical Services During the COVID-19 Public Health Emergency Period The American Medical Association (AMA) just announced updates to the Current Procedural Terminology (CPT) code set that includes two code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic. The first addition, CPT code 99072, allows for the provision of evaluation, treatment, or procedural services during a public health emergency in a setting where extra precautions are taken to ensure the safety of patients as well as health care professionals. The second addition, CPT code 86413, was approved in response to the development of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies, as opposed to a qualitative assessment (positive/negative) […]

Comments on Proposed Rules for Payment Systems and Medicare Physician Fee Schedule due October 5 In August, CMS published the calendar year (CY) 2021 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule and the Medicare Physician Fee Schedule Proposed Rule. The deadline for comments on both rules is October 5, 2020. ISASS will submit comments on both rules by the deadline, but for individual members and practices interested in submitting comments, please see links below to submit comments. You can read the ISASS summary of the Medicare Physician Fee Schedule Proposed Rule Here. To submit comments on the Medicare Physician Fee Schedule Proposed Rule, click here: Comment Here You can read the ISASS […]