May 29, 2019

UPDATE: Specialty Societies Provide Input on Updates to Medicare Quality Payment Program, and Submit Letter to Members of Congress

In May, a group of national medical specialty societies provided input to federal lawmakers and regulators on steps to improve the Medicare Quality Payment Program (QPP). In a document released to U.S. Members of Congress and to administrators with the U.S. Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), the societies outlined several areas where lawmakers and regulators could improve the current Medicare QPP. The QPP is intended to provided payment and incentives to healthcare providers for improving quality and value to patients. Among the recommendations were updates to the Merit-based Incentive Payment System (MIPS) under QPP and the Alternative Payment Model (APM) system under QPP. For MIPS, recommendations included: Provide scoring flexibility to […]
May 29, 2019

CMS Announces Payment and Policy Initiatives to Encourage Greater Adoption of Innovative Medical Technologies

At a meeting on May 2, at the Medical Device Manufacturers Association (MDMA) Annual Meeting, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma publicly announced the agency’s comprehensive strategy to improve patients’ access to emerging technologies. Administrator Verma’s remark build on recently released CMS policies designed to promote innovation in the U.S. healthcare system. The Administration hopes that encouraging a competitive and innovative market will lead to lower overall healthcare costs for patient and the government and to increases in the quality of and access to healthcare for all Americans, including Medicare and Medicaid patients. Verma highlighted two specific actions in the address. First, CMS has recently announced changes to the process of updates and issuing Healthcare Common […]
May 29, 2019

CMS Updates Medicare Payment rates for Low Volume Procedures, Including Dozens of Spine Surgery Procedures

As part of CMS’ quarterly update for 3rd Quarter 2020, the Agency announced retroactive changes to the Professional Liability Insurance (PLI) Relative Values (RVUs) for dozens of procedures paid under the Medicare Physician Fee Schedule. The PLI RVUs are one of the three components, the other two being “work” and “practice expense” of the Medicare Total RVU for Physician payments for Medicare services.  The adjustments are positive for spine surgical procedures, varying from .50 RVUs to 1.50 RVUs. The updated payments will be automatically updated by Medicare for all Medicare claims made from July 1, 2019 through December 31, 2019, but was also made retroactive to January 1, 2019. Providers who billed Medicare for any of the CPT codes listed […]
May 3, 2019

ISASS asks CMS to consider C-code for Barricaid Implant system

ISASS sent the Center for Medicaid and Medicare Services a letter May 3, asking it to consider applying a C-code to the Barricaid Implant system. CMS C-codes are used for new technologies and new devices that are used in outpatient settings such as the Barricaid Implant system.  If approved, C-codes only apply to the facility payments, and physician payment and coding is separate.  Typically, technologies that gain C-code approval can see greater adoption and allow greater research and insight into outcomes and efficacy.  If approved, Barricaid would receive approval for C-code status for FY 2019. See the full text of the ISASS letter to CMS Regarding Barricaid System