MACS to Hold Certain 2015 Date-of-Service Claims – CMS announced on December 29, 2014, that Medicare Administrative Contractors will hold claims containing 2015 services paid under the Medicare Physician Fee Schedule (MPFS) for the first 14 calendar days of January 2015 (i.e., from January 1 through January 14). The claims are being held to implement corrections to technical errors discovered after the CY 2015 MPFS final rule was published on November 13, 2014. The hold is expected to have minimal impact on provider cash flows in light of the typical paid claims timeline. Additional information about the hold can be found here.
MedPAC Two-Day Meeting Focuses on Payment Adequacy – Last month the Medicare Payment Advisory Committee (MedPAC) hosted a two-day meeting assessing payments provided under Medicare for acute care hospitals, long-term care hospitals, physician services, ambulatory surgical centers, hospices, skilled nursing facilities, home health, dialysis, and inpatient rehabilitation facilities. Among the proposals discussed at the meeting, MedPAC discussed its draft payment recommendations for hospitals that would reduce certain outpatient rates to rates similar to those provided for services at physician offices, reduce long-term care hospital payments and instead apply those funds to additional outlier payments to acute care hospitals, and increase payments generally to acute care hospitals. The net increase in payments of 2.5 percent in 2016 would amount to 2.25 percent over current law. MedPAC will vote on the recommendations in January and publish its final report in March. Slides from the meeting are available here, and a transcript of the meeting is available here.
MedPAC Reports that Home Health Rebasing is Unlikely to Affect Access or Quality – On December 14, 2014, the Medicare Payment Advisory Commission (MedPAC) released a report addressing the impact of Affordable Care Act mandated home health payment rebasing on beneficiary access and quality of care. The required rebasing began in 2014, which was the first of four years of base-payment reductions in the home health prospective payment system. The Affordable Care Act required MedPAC to submit the report to Congress no later than January 1, 2015 – a deadline which hindered MedPAC from directly assessing the impact of rebasing because claims and quality data for 2014 was not yet available to MedPAC. MedPAC therefore examined data from 2001 through 2012 to assess whether past changes in the average payment per home health episode impacted quality or access and concluded that prior payment reductions did not have a negative effect on home heath quality or beneficiary access to care. MedPAC’s full report can be found here.
Lawmakers Urge HHS to Shorten 2015 Meaningful Use Reporting Period – In a letter to HHS, a group of lawmakers requested that HHS shorten the full-year reporting period for EHR meaningful use in 2015 to 90 days. Noting that data from CMS indicates that less than 35 percent of eligible hospitals have demonstrated stage 2 capabilities in 2014 with a 90-day reporting period, the lawmakers asked that HHS respond to the request by mid-January.
