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Showing posts with label CMS. Show all posts
Showing posts with label CMS. Show all posts

Friday, July 12, 2013

ATA Responds to CMS Proposal for Expanded Telemedicine Coverage

Press Release
The American Telemedicine Association
Originally published July 10, 2013

The American Telemedicine Association voices its cautious support for new proposals by the Centers for Medicare and Medicaid Services (CMS) that would expand Medicare’s telehealth footprint.  CMS proposes to increase the number of beneficiaries eligible for telemedicine by modifying their urban/rural definitions and proposes several new reimbursable telemedicine services.

“Overall, the proposed rules are good news for Medicare patients and forward-thinking healthcare providers. We applaud CMS for taking steps to help these patients benefit from proven telemedicine technologies,” said Jonathan Linkous, Chief Executive Officer of the American Telemedicine Association. "But many potential beneficiaries are still left behind.  For example, we hope that either CMS or Congress take additional steps to restore telehealth benefits to the one million beneficiaries in 104 counties that lost coverage last year due to reclassification to metropolitan areas.”

The entire story is here.

Thanks to Alex Siegel for this information

Tuesday, February 19, 2013

SGR Repeal Bill Favors Primary Care

Robert Lowes
MedScape Medical News
Originally published February 06, 2013

Two members of Congress today reintroduced an ambitious bill that would repeal Medicare's sustainable growth rate (SGR) formula for setting physician pay and gradually phase out fee-for-service (FFS) reimbursement.

One major difference this time around for the bipartisan bill, originally introduced in May 2012, is that its price tag appears considerably lower, making passage more likely.

When Reps. Allyson Schwartz (D-PA) and Joe Heck, DO (R-NV), proposed this legislation last year, the Congressional Budget Office (CBO) had estimated that repealing the SGR and merely freezing current Medicare rates for 10 years would cost roughly $320 billion.

Since then, the CBO has reduced that 10-year estimate on the basis of lower than projected Medicare spending on physician services for the past 3 years. In a budget forecast released yesterday, the agency put the cost of a 10-year rate freeze at $138 billion.

The immediate effect of the bill from Schwartz and Dr. Heck, titled the Medicare Physician Payment Innovation Act, would be to avert a Medicare pay cut of roughly 25% on January 1, 2014, that is mandated by the SGR formula. Instead, the bill maintains 2013 rates through the end of 2014.

After 2014, Medicare would begin to shift from FFS to a methodology that rewards physicians for the quality and efficiency of patient care. From 2015 through 2018, the rates for primary care, preventive, and care coordination services would increase annually by 2.5% for physicians for whom 60% of Medicare allowables fall into these categories. Medicare rates for all other physician services would rise annually by 0.5%.

Meanwhile, the bill calls on the Centers for Medicare & Medicaid Services (CMS) to step up its efforts to test and evaluate new models of delivering and paying for healthcare (experiments with medical homes, accountable care organizations, and bundled payments are already underway). By October 2017, CMS must give physicians its best menu of new models to choose from. Two menu options would allow some physicians unable to fully revolutionize to participate in a modified FFS scheme.

The entire article is here.

Saturday, February 16, 2013

CMS Issues Sunshine Rule


By Joyce Frieden, News Editor, MedPage Today
Published: February 01, 2013


The Centers for Medicare and Medicaid Services issued a long-awaited rule Friday finalizing the details for a database that will list payments made to physicians by pharmaceutical and device manufacturers.

"You should know when your doctor has a financial relationship with the companies that manufacture or supply the medicines or medical devices you may need," Peter Budetti, MD, the agency's deputy administrator for program integrity, said in a statement. "Disclosure of these relationships allows patients to have more informed discussions with their doctors."

The rule, a provision of the Affordable Care Act known as the Physician Payments Sunshine Act, "finalizes the provisions that require manufacturers of drugs, devices, biologicals, and medical supplies covered by Medicare, Medicaid, or the Children's Health Insurance Program to report payments or other transfers of value they make to physicians and teaching hospitals to CMS," the statement explained. "CMS will post that data to a public website. The final rule also requires manufacturers and group purchasing organizations (GPOs) to disclose to CMS physician ownership or investment interests."

Data collection will start on Aug. 1, CMS said, noting that "Applicable manufacturers and applicable GPOs will report the data for August through December of 2013 to CMS by March 31, 2014 and CMS will release the data on a public website by Sept. 30, 2014. CMS is developing an electronic system to facilitate the reporting process."

The rule "is intended to help reduce the potential for conflicts of interest that physicians or teaching hospitals could face as a result of their relationships with manufacturers," the statement continued.

The American Medical Association responded cautiously to the release of the final rule. "The AMA will carefully review the new Physician Payment Sunshine Act rule," AMA President Jeremy Lazarus, MD, said in a statement. "Physicians' relationships with the pharmaceutical industry should be transparent and focused on benefits to patients ... As the rule is implemented, we will work to make sure physicians have up-to-date information about the new reporting process."

The entire story is here.