News

On October 30, 2015, the Centers for Medicare and Medicaid Services (CMS) released the final 2016 Physician Fee Schedule (PFS). In the final rule, CMS finalizes RVUs for Calendar Year (CY) 2016 for the PFS and other Medicare Part B payment policies to ensure that CMS payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This is the first PFS final rule since the repeal of the Sustainable Growth Rate formula by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The final rule goes into effect on January 1, 2016. CMS is accepting public comments on the final rule until 5 p.m. EST on December […]

ISASS signed on to an AMA letter to Congress urging intervention to reform and refocus the electronic health record (EHR) meaningful use program. The American Recovery and Reinvestment Act of 2009 (ARRA) established incentive payments to eligible professionals, eligible hospitals, critical access hospitals and Medicare Advantage Organizations to promote the adoption and meaningful use of interoperable health information technology and qualified electronic health records. The State 1 final rule (2011-2012) set the foundation for the Medicare and Medicaid EHR incentive programs by establishing requirements for the electronic capture of clinical data, including providing patients with electronic copies of their health information. The Stage 2 final rule (2014) expanded upon the Stage 1 criteria and encouraged use of health information technology […]

News and noteworthy information for October: Medicare Administrative Contractor News GAO appoints HHS Advisory Committee on Physician Payment Models Developing New Physician Payment Models: Comprehensive Care for Joint Replacement Model—A Preview of What’s to Come in Spine Request for Information on New Provisions of MACRA Physician Compare Preview Period Informal Review Request Period for the 2016 Value Modifier Physician Quality Reporting System Payment Adjustment and Informal Review Process CMS Issues Final Electronic Health Record Rules Budget Agreement Reached Between Congressional Leaders and Administration President Obama Announces Joint Effort to Combat Opioid Abuse 2016 Final Physician Fee Schedule & Hospital Outpatient and ASC Final Rule   Medicare Administrative Contractor News NGS Medicare – Draft LCD for MIS SIJ Fusion (DL36406) CGS […]

ISASS signed on to an AMA letter to the National Association of Insurance Commissioners (NAIC) regarding updates to the Network Adequacy Model Act. NAIC is the standard-setting and regulatory support organization in the United States created and governed by the chief insurance regulators from the 50 states, Washington D.C. and five U.S. territories. NAIC is currently working to update its 1996 Network Adequacy Model Act which is used as a template to draft/update state statutes that regulate the insurance industry. The letter touches upon three areas of concern and presents corresponding recommendations to strengthen patient protections in the Model Act: 1. require prior approval of networks before health plans are sold; 2. require states to institute measurable quantitative standards for network adequacy; and 3. include stronger protections for tiered networks. Letter to NAIC […]