President Trump Signs into Law the Bipartisan Funding Bill; Medicare Accelerated and Advance Payment Program Loan Repayment Extended
On Thursday, October 1, the President signed the bipartisan government funding bill that averts a shutdown and will relax Medicare Accelerated and Advance Payment Program loan repayment terms for health care providers.
The stopgap measure extends the deadline for government funding and finances several Medicare and Medicaid programs, including cuts to Medicaid disproportionate-share hospital payments, to December 11. The bill passed the Senate on Wednesday, September 30 after passing the House last week.
The bill would give providers one year after the Medicare Accelerated and Advance Payment Program loan was issued before recoupment would begin, an extension from 120 days under current law. The recoupment rate would also be lowered from its current 100% level to 25% for the first 11 months of repayment, and 50% for the six months afterward. ASCRS and the medical community have been advocating for this change.
Join Your Colleagues in our Grassroots Effort Asking Your Representative to Sign the Bera/Bucshon letter to the House Leadership Urging Action to Prevent the Pending Medicare Physician Payment Cuts Scheduled to Take Effect on January 1, 2021
To date, over 600 letters have been generated by ASCRS and ASOA members urging their congressional representatives to sign the bipartisan congressional sign on letter to the House leadership being led by Representatives Ami Bera, MD (D-CA), and Larry Bucshon, MD (R-IN). The letter urges the leadership to address the pending Medicare physician payment reductions before the end of the year. To date, over 70 members of the House of Representatives have signed the letter.
If you have already reached out to your representative, thank you. If you have not, please use the ASCRS Grassroots Action Center to send your letter. All you have to do is sign in – provide your zip code and the background information and a letter will pop-up. You may personalize the letter before sending.
It is important that members of Congress hear directly from you. They need to hear how these cuts will impact you, your practice, and your patients.
Thanks for your participation!
ASCRS and OOSS Submit Comments on Medicare Physician Fee Schedule Proposed Rule for 2021; Urge CMS to Work with Congress to Prevent the Drastic Physician Payment Reductions Scheduled to Take Effect
On October 1, 2020, ASCRS and OOSS submitted comments to CMS regarding the Medicare Physician Fee Schedule Proposed Rule for 2021. We urge CMS to use its authority and work with Congress to prevent the pending reductions due to the 10.6% reduction in the conversion factor, and we express opposition to policies related to the Evaluation and Management (E/M) codes that are contributing to the reduction, including the creation of an unnecessary add-on code and the failure to incorporate the revised E/M values in the global surgical codes.
Specifically, CMS is moving forward with the addition of the add-on code for management of patients with chronic conditions. This code was originally proposed by CMS to address inequities in the original E/M overall proposal that would have collapsed the E/M codes. However, after opposition from the medical community, that proposal was not adopted, and the higher level 4 and 5 codes have been maintained with significant increases. As a result, the add-on code is no longer necessary.
CMS also continues to refuse to apply the same increases for the E/M codes to the post-op visits included in the 10- and 90-day global surgical codes. In addition, we express our support for the expansion of certain telehealth flexibilities and coverage beyond the public health emergency (PHE) to ensure our members can continue to maximize the benefits of telehealth and enhance patient access to care, as well as provide comment on the proposed changes to the Quality Payment Program for 2021.
ASCRS also signed onto the Alliance of Specialty Medicine’s comment letter – and is planning to join nearly 100 provider group coalition in an additional comment letter specifically focused on the E/M issue.
Ranking Member of the House Energy and Commerce Health Subcommittee, Representative Michael Burgess, MD (R-TX), Introduces Legislation to Address Pending Medicare Physician Payment Reductions
Today, October 2, Representative Michael Burgess, MD, introduced H.R. 8505 to address the pending Medicare physician payment reductions scheduled to take effect on January 1, 2021. The legislation uses the Provider Relief Fund to finance the waiving of budget neutrality for one year.
HHS Announces New $20 Billion Phase 3 Provider Relief Fund Distribution
On October 1, the Department of Health and Human Services (HHS) announced that it will be disbursing another $20 billion in CARES Act Provider Relief Funds. Under this Phase 3 General Distribution allocation, physicians that have already received Provider Relief Fund payments may apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus.
Recognizing the negative impact of the COVID-19 pandemic has increased anxiety and depression in the country and behavioral health providers have continued to provide care through telehealth and other means, HHS is also announcing that the nation’s behavioral health care providers, including psychiatrists, are now eligible for funding. Previously ineligible physicians, such as those who began practicing in 2020, will also be eligible to apply.
Physicians will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding.
ASCRS ASOA Release Guidance on Hybrid Telehealth Visits for Ophthalmology Practices
Many scenarios lend themselves to hybrid telehealth visits for ophthalmology practices. While COVID-19 was the starter for many practices, the hybrid visit will continue to allow practices to increase efficiency and access to care moving forward. In addition to minimizing wait times, hybrid visits allow physicians to see their patients from multiple locations, with greater scheduling flexibility, including after-hours and on the weekends. It will be important for practices to develop protocols to ensure compliance and maintain an excellent patient-physician workflow. The guidance provides a few scenarios to consider.
The guidance was prepared by Ranya Habash, MD, Medical Director, Technology Innovation and Assistant Professor of Clinical Ophthalmology, Bascom Palmer Eye Institute, Member of the ASCRS Telemedicine Task Force; Laurie Brown, MBA, COMT, COE, CPC, CPMA, OSC, Senior Consultant, BSM Consulting; and, Kirk Mack, COMT, COE, CPC, CPMA, Senior Consultant, BSM Consulting.
House Approves a Revised $2.2 Trillion Corona Relief Package; Speaker of the House Nancy Pelosi (D-CA) and Treasury Secretary Steven Mnuchin Continue to Talk
On Wednesday evening, October 1, the House passed the Democrats’ $2.2 trillion Corona Relief Package by a vote of 214 to 207; 18 Democrats voted against the bill. Some of them encouraged the Speaker to accept the $1.6 offer from the treasury secretary. Even though House lawmakers are scheduled to return to their districts today and are not scheduled to return until after the election, House Speaker Nancy Pelosi and Treasury Secretary Steven Mnuchin have indicated they will keep negotiating. The bill is unlikely to move in the Senate.