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Healthcare News: Congress on Infrastructure, Biden Admin Competition Reforms

Friday, July 16, 2021 This Week s Dose Senate Democrats reach partisan agreement on human infrastructure package. Centers for Medicare and Medicaid Services (CMS) release proposed physician payment rule that addresses coverage for telemedicine services and reduces the conversion factor by 3.75%. Biden directs agencies to consider reforms to enhance competition.  Congress Senate Democrats Announced $3.5 Trillion Human Infrastructure Package. Senate Majority Leader Chuck Schumer announced the package late Tuesday night, which represents Biden Administration priorities that Democrats will seek to push through using a second attempt at reconciliation. While Democrats have not yet released any legislative text or itemized breakdowns of how the $3.5 trillion will be spent, initial reports indicate that the package will expand Medicare benefits to cover dental, hearing and vision services and address the Medicaid coverage gap in non-expansion states. There are also likely to

CMS Proposes Cut to Conversion Factor in Medicare Physician Fee Schedule

email article WASHINGTON The Centers for Medicare & Medicaid Services (CMS) proposed 2022 Physician Fee Schedule (PFS) rule for Medicare would lower the amount physicians are paid under fee-for-service Medicare and change the requirements for incentives under the Quality Payment Program. The changes, announced at 8 p.m. Tuesday, include a decrease in the conversion factor the multiplier that Medicare applies to relative value units (RVUs) to calculate reimbursement for a particular service or procedure under Medicare s fee-for-service system. Due to budget neutrality changes required by law and the expiration of a 3.75% payment increase provided by Congress, the proposed CY [calendar year] 2022 PFS conversion factor is $33.58, a decrease of $1.31 from the CY 2021 PFS conversion factor of $34.89, CMS said in a fact sheet. The PFS conversion factor reflects the statutory update of 0.00% and the adjustment necessary to account for changes in relative value units an

New Rules for Some Medicare ACOs Are No Good, Say Healthcare Groups

email article WASHINGTON Groups representing doctors, hospitals, and accountable care organizations (ACOs) are pushing back on changes to quality reporting rules for Medicare Shared Savings Program (MSSP) ACOs that were finalized under the Trump administration. We have significant concerns about the MSSP quality policies finalized at the very end of 2020, a group of 11 healthcare organizations, including the National Association of ACOs (NAACOS), the American Medical Association, and the American Hospital Association wrote in a seven-page letter sent to HHS Secretary Xavier Becerra at the end of April. We believe there is an important opportunity for CMS to revise aspects of the recently finalized MSSP policies to better support ACOs and promote high-quality patient care.

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