November 24, 2020

Study Published on Medicare Utilization and Spending During COVID-19 Crisis

Study Published on Medicare Utilization and Spending During COVID-19 Crisis On October 8, 2020, the Department of Health and Human Services published a study on Medicare utilization and spending in 2020 to analyze utilization and spending trends during the COVID-19 Emergency. The study, which was conducted by the Assistant Secretary for Policy and Evaluation Office of Health Policy, reported several key findings, including: Medicare beneficiary utilization of services declined substantially beginning in mid-March 2020, bottomed out the week ending April 8, and increased through June. Payments for all fee-for-service claims declined by 39% in the week ending April 8—33% for inpatient services and 49% for physician services. By the week ending July 1, weekly payments had nearly returned to 2019 […]
November 24, 2020

CMS Announces New Repayment Terms for Medicare Loans Made to Providers During COVID-19

CMS Announces New Repayment Terms for Medicare Loans Made to Providers During COVID-19 On October 1, 2020, the Department of Health and Human Services (HHS) announced that it will be disbursing another $20 billion in CARES Act Provider Relief Funds. Under this Phase 3 General Distribution allocation, physicians who have already received Provider Relief Fund payments may apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. The negative impact of the COVID-19 pandemic has increased anxiety and depression in the country, and behavioral health providers have continued to provide care through telehealth and other means. Thus, HHS is also announcing that the nation’s behavioral health care providers, including psychiatrists, are now eligible for funding. Previously […]
November 24, 2020

AMA/Multi-Specialty Relative Value Update Committee (RUC) Reimbursement Surveys for Spine Surgical Procedures

AMA/Multi-Specialty Relative Value Update Committee (RUC) Reimbursement Surveys for Spine Surgical Procedures The RUC acts as an advisory body to CMS in setting Relative Value Units (RVUs) in the Medicare Physician Fee Schedule. As part of their valuation process, the RUC works with specialty societies like ISASS to survey specialty society members on their relative resource use in providing services. In the coming weeks, ISASS will be working with the RUC on multiple resource surveys for spine procedures. We ask ISASS members to be prepared to respond to any requests to participate. The surveys take 15-20 minutes to complete and provide important information to the RUC and to CMS in determining RVUs. The procedures being surveyed include ablation of the […]
November 24, 2020

ISASS Comments on 2021 Medicare Outpatient Prospective Payment System/Ambulatory Surgical Center (OPPS/ASC) Proposed Rule

ISASS Comments on 2021 Medicare Outpatient Prospective Payment System/Ambulatory Surgical Center (OPPS/ASC) Proposed Rule ISASS submitted a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the 2021 OPPS/ASC Proposed Rule on October 2, 2021. The ISASS letter addressed several areas of interest and relevance to ISASS members, including the proposed reduction in Medicare physician payments for 2021. In the letter, ISASS objected to the CMS proposal to require prior authorization for cervical fusion and spinal neurostimulator simulation procedures performed in the OPPS or ASC settings. ISASS cited several published studies on the costs to patients and providers with prior authorization requirements and urged CMS to revise their proposal and not require prior authorization for these procedures. […]