The July 11 Federal Register includes the proposed 2015 Medicare Physician Fee Schedule from the Centers for Medicare & Medicaid Services (CMS). Several proposed changes may cause a stir, particularly one that would remove an exemption from the Sunshine Act for continuing medical education. Doing away with the exclusion would require pharmaceutical and device makers to disclose any amounts paid to physician CME presenters.
A number of other key changes are planned for 2015, including new policy on the:
- Shared Savings Program for accountable care organizations
- Physician Quality Reporting System
- Incentive payments for meaningful use of electronic health records
Regarding telehealth, CMS proposes adding to the list of reimbursable services to include annual wellness visits, psychoanalysis, psychotherapy and prolonged evaluation and management.
Last year, CMS finalized a separate payment, outside of a face-to-face visit, for managing care of Medicare patients with two or more chronic conditions – set to start in 2015. In this year’s rule, CMS proposes more details about that policy, including payment rates.
Other points in the proposed rules you may want to note include:
- The pay rates for physician services and an anticipated negative 20.9 percent update due to the sustainable growth rate (SGR) formula – without congressional intervention – after March 1, 2015 (first quarter)
- A proposal to transition all 10- and 90-day global period codes to 0-day global periods starting in 2017, in response to an Office of Inspector General report and other concerns about misevaluation of surgical services
- Continued implementation of the value-based payment modifier (VBPM) by applying the 2017 VBPM to solo practitioners and eligible professionals – physician and nonphysician – in groups of two or more, with maximum payment risk under the VBPM from 2 percent in 2016 to 4 percent in 2017 (based on 2015 performance)
See the proposed rules in the Federal Register. Then be sure to send your comments by the Sept. 2 deadline.
Find a CMS Fact Sheet here.