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Healthcare Policy News
2022 Payment Changes Finalized in Medicare Physician Fee Schedule
On Nov. 2, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2022 Medicare Physician Fee Schedule. The finalized rule, set to take effect on Jan. 1, 2022, implements several changes including updating the policy for split evaluation and management visits and allowing Physician Assistants to directly bill Medicare for Part B services. It also extends current telehealth flexibilities through CY 2023 and creates new payment options for extended virtual check-in visits, both asks of AAOS in its September comment letter. Unfortunately, CMS is implementing the planned 3.75% cut to the conversion factor which AAOS is actively working with Congress to mitigate. The agency also finalized the Improving Care for Lower Extremity Joint Repair MIPS Value Pathway (MVP); however, implementation will be delayed until January 1, 2023. Read the CMS fact sheet…
IPO Elimination Reversal Finalized in 2022 Medicare Outpatient Prospective Payment System
On Nov. 2, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2022 Medicare Hospital Outpatient Prospective Payment System/Ambulatory Surgical Center (OPPS/ASC) final rule. In a significant win for AAOS advocacy (see September comment letter), CMS heeded patient safety concerns and is reversing its abrupt elimination of the Inpatient Only List. Fortunately, several procedures that AAOS requested—including reconstruction of ankle and shoulder joints, as well as lumbar spine fusion—will remain off the list and be reimbursable in the outpatient setting. The 255 procedures that were added to the ASC Covered Procedures List (CPL) in 2021 will be removed, and a new stakeholder nomination process for adding procedures to the list will begin in March 2022. In line with these policy reversals, CMS is returning to a two-year exemption period from medical review activities related to the 2-midnight rule following the removal of a procedure from the IPO list. Read the CMS fact sheet…
Emergency Regulation Issued Requiring COVID-19 Vaccination for Health Care Workers
The Biden-Harris Administration issued an emergency regulation yesterday requiring COVID-19 vaccination of eligible staff at health care facilities that participate in the Medicare and Medicaid programs. According to a press release from the Centers for Medicare and Medicaid Services, the regulation protects those fighting the virus on the front lines while also delivering assurances to individuals and their families that they will be protected when seeking care. These requirements will apply to approximately 76,000 providers and cover over 17 million health care workers across the country–notably, physician offices are exempt unless they are a part of a larger system. Facilities covered by this regulation must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by December 5, 2021. All eligible staff must have received the necessary shots to be fully vaccinated – either two doses of Pfizer or Moderna or one dose of Johnson & Johnson – by January 4, 2022. See the FAQ… |
