AANEM Practice News Express

AANEM News Express

CMS Releases Final Rule: 2018 Medicare Physician Fee Schedule

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a
final rule updating payment policies and payment rates for physicians under the Medicare Physician Fee Schedule (MPFS) for 2018. CMS estimates a 0% impact in payment for neurology and physical medicine and rehabilitation physicians. 

CMS Releases Proposed Rule: 2018 Medicare Physician Fee Schedule

On July 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a 
proposed rule updating payment policies and payment rates for physicians under the Medicare Physician Fee Schedule (MPFS) for 2018.  CMS estimates a 0% impact in payment for neurology and +1% for physical medicine and rehabilitation physicians; although, ultimately, the result could differ when the final rule is published in the fall.

MACRA: CMS Releases Proposed Rule for Year 2 of the Quality Payment Program

On Tuesday, June 20, the Centers for Medicare and Medicaid Services (CMS) issued its
proposed rule for Year 2 of the Quality Payment Program (QPP), established under MACRA. Several of AANEM’s suggestions were adopted in the proposed rule. Of key importance is that CMS is, essentially, providing for another transition year. Under this rule, it is estimated that 94% or more of eligible clinicians would earn a positive or neutral payment adjustment. For information about the rule in effect for the current year, visit AANEM’s MACRA webpage: https://www.aanem.org/Practice/Medicare/MACRA
Based on a cursory review of the rule, it appears that CMS listened to extensive feedback provided by various medical associations and groups, including the AANEM, and made several changes to the QPP based on physician input. 

AANEM Meets with CMS to Discuss Ensuring Quality in EDX Medicine

On Monday, June 26, representatives of the AANEM met with leaders of CMS to discuss problems and potential solutions related to quality EDX care. Drs. Peter Grant and Vince Tranchitella described some of the current fraud and abuse trends in EDX medicine and suggested potential solutions including adopting AANEM’s EDX Laboratory Accreditation Program as prerequisite for billing Medicare patients.  This is similar to what was done in sleep medicine with their sleep labs. Other options discussed included adopting specific requirements in the Accreditation Program.
CMS officials acknowledged that they are aware of the issues and shared a memo that was sent to all Medicare Administrative Contractors (MACs) back in December 2016. The memo urged MACs to keep an eye out for:
  • Physicians with an unusually high average number of EDX test claims for the same beneficiary on the same day; and Physicians with an unusually high percentage of EDX test claims without both an NCS and a needle EMG. 

Recap: 2017 AMA House of Delegates Annual Meeting

The American Medical Association (AMA) House of Delegates (HOD) met in Chicago, IL on June 10-14, 2017 for its annual meeting. Important issues reviewed by the HOD included: effectively addressing the current opioid crisis while seeking strategies and education to help those living with chronic pain, collaborating with the VA to ensure veterans have access to quality care and calling for new funding for the Veterans Choice Program, and defending access to quality care for refugees and detained immigrants.
AANEM was represented at the meeting by Bill Pease, MD, delegate, and Enrica Arnaudo, alternate delegate.

Registration Period for MIPS Group Reporting Ends on June 30

Q. Should I report as a group or as an individual? A. If you work in group practice, you have the choice to report as an individual or as a group. However, if you decide to report as a group, ALL eligible clinicians must report under the group’s tax identification number (TIN) – no one is allowed to report individually. Similarly, if your group elects to report together, even if you would be exempt under the low-volume threshold on the individual level, you MUST participate with the group. Under the group reporting option, all eligible clinicians will report on the same measures in each of the four categories.

Take This 1 Step to Avoid a 4% Medicare Cut

Q. Can I participate in MIPS without an EHR? A. Yes. In an effort to encourage eligible clinicians to participate in MIPS in 2017 (and avoid the 4% penalty), CMS has deemed 2017 a “transition year” and is allowing clinicians to participate by reporting as little as ONE quality measure on ONE patient. There are several quality measures that may be of relevance to AANEM members that do not require an EHR.

Diagnostic Value of Sonography in Treatment-naïve Chronic Inflammatory Neuropathies

Physicians often need to distinguish inflammatory neuropathies from other neuropathies and motor neuron disorders. This study in Neurology discusses the use of ultrasound for diagnosis, and underlines that testing has robust merit.

CMS Lookup Tool—Determine Your MIPS Participation Status

The Center for Medicare and Medicaid Services (CMS) has released a new lookup tool that can help clinicians determine their Merit-Based Incentive System (MIPS) participation status. You should have also received a letter (or should in the next week or so) indicating whether or not you are eligible to participate in MIPS. 

Two Studies on Spinal Muscular Atrophy and Nusinersen

SMA is the most common genetic cause of infant death. In December 2016, Nusinersen, became the first approved drug to treat SMA while several other compounds remain in clinical trials. These studies in Neuron and the Lancet demonstrate potential effectiveness.







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