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CMS Proposes New Rule Change to The Medicare Physician Fee Schedule and Quality Payment Program

July 2018 – On July 12, 2018, the Centers for Medicare & Medicaid Services (“CMS”) proposed rules aimed at fundamentally improving the nation’s healthcare system and restoring the doctor-patient relationship. The proposal is “one of the most significant reductions in provider burden undertaken by any administration,” according to CMS director Seema Verma. The new proposed rules include the promotion of digital health technology, expanded telemedicine coverage, new documentation requirements, and a newly developed focus on interoperability.

The proposed rules are promoting digital health technology by expanding telemedicine coverage. According to the new rules, CMS will start to pay physicians for virtual check-ins over the phone with their patients to see if the need to come in for an office visit and will also pay them for remote evaluation of images and videos taken by their patients. The intended purpose of this proposed rule is to ameliorate patient concerns in a convenient manner by reducing unnecessary cost to the system with needless office visits.

Moreover, the enactment of the proposed rules would overhaul the current documentation requirements. Instead of having a system with four kinds of documentation requirements, the proposed rules would create a system with one set of documentation requirements that would have four distinct code levels. The overhaul is estimated to save clinicians an estimated 51 hours per year if 40% of their patients are in Medicare. The idea is to have the clinicians documenting material that will capture the patient’s health data rather than spending time typing information to bill a certain level of code.

The overhaul in documentation requirements will allow clinicians more time to use their electronic health records (EHRs) to document useful relevant information about their patient. By getting a more accurate picture of each patient, the CMS proposal includes alterations to the Merit-based Incentive Payment System (MIPS) that encourages patients to access their health information.

Public comments on the proposed rules are due by September 10, 2018.

Click here to access the CMS press release

Click here to access CMS’s Proposed Rules PDF

Click here to access an article regarding the proposed rules

For more information on this topic, please contact Adrienne Dresevic, Esq., Clinton Mikel, Esq., or Jessica Gustafson, Esq at (248) 996-8510 or by email at adresevic@thehlp.com, cmikel@thehlp.com, or jgustsafson@thehlp.com

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