LEGISLATIVE NEWS-ON THE HILL
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Bipartisan Legislation Introduced to Repeal Flawed Sustainable Growth Rate (SGR) and Reform Medicare Physician Payment System
On May 9, U.S. Reps. Allyson Schwartz (D-PA) and Joe Heck, D.O. (R-NV), introduced bipartisan legislation permanently repealing the flawed SGR formula and providing for several years of small positive updates while new delivery models are being tested. The bipartisan Medicare Physician Payment Innovation Act prevents the nearly 30 percent cuts to physician payments scheduled for Jan. 1, 2013. The legislation would also freeze payments to physicians at 2012 levels through Dec. 31, 2013. It would then provide positive annual increases of 0.5% for all physician services each year for four years, with primary care physicians receiving a 2.5 percent increase for several years, and instructs CMS to develop a minimum of four healthcare delivery and payment reform models by Oct. 1, 2016, to provide options for providers across medical specialties, practice types, and geographic regions. However, physicians who remain in fee-for-service will be penalized by -14 percent through a transition of penalties, with fees then being frozen, which is a key concern for specialty physicians. The cost of repealing the SGR would be paid for fully by savings from reductions in military operations in Iraq and Afghanistan, also known as the Overseas Contingency Operations.
Centers for Medicare & Medicaid Services (CMS) Delays Reporting Deadline for Sunshine Act to January, 2013
On May 3, CMS announced that manufacturers will not be required to collect data under the Physician Payments Sunshine Act, a provision in the Patient Protection and Affordable Care, before January 1, 2013. The act originally required data collection to begin Jan. 1 of this year. According to the notice, the postponement of required data collection will give CMS an opportunity to address over 300 comments submitted on the proposed rule and will give applicable manufacturers additional time to prepare for transparency report submission. As we have reported, the sunshine provisions require manufacturers of drugs, devices, biologicals, and medical supplies that are covered under Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) to report annually to CMS certain payments or other transfers of value to physicians and teaching hospitals. Although the statute requires the first report to be submitted by March 31, 2013, for payments made in calendar year 2012, it appears likely that the deadline for the first transparency reports will also be extended.
Charles Grassley (R-IA) and Herb Kohl (D-WI), who authored the legislation, contacted acting CMS Administrator Marilyn Tavenner with questions regarding CMS’ expected start date and expressed disappointment that the process has exceeded the statutory deadline for implementation. Tavenner, in her letter of response to Sen. Grassley, stated that CMS has identified a work group that is currently assessing the staff and resource requirements for full implementation of the program. The letter also noted CMS plans to issue a request for proposal this year to further aid with implementation. The final rule is expected to be published later this year.
New Rules Reduce/Eliminate Outdated Regulatory Requirements for Health Care Providers
On May 10, the CMS issued new two rules aimed at removing unnecessary regulatory and reporting requirements currently imposed on hospitals and other healthcare providers, with a projected savings more than $5 billion over the next five years. The Medicare Regulatory Reform Rule addresses regulatory of requirements for providers other than hospitals and is estimated to save up to $200 million in the first year. Examples of these reforms include updating obsolete e-prescribing technical requirements to meet current standards and eliminating other out-of-date and overly prescriptive requirements for healthcare providers, including outdated infection control instructions for Ambulatory Surgical Centers (ASCs). The Medicare Conditions of Participation Rule updates the requirements for hospitals that treat Medicare and Medicaid patients. For example, this rule eliminates outdated hospital management requirements as well as various unnecessary reporting requirements.
The two final rules are a result of the January 2011 Executive Order on Improving Regulation and Regulatory Review calling for the improvement of the federal regulatory system and for it to ”identify and use the best, most innovative, and least burdensome tools for achieving regulatory ends.”
House Energy and Commerce Committee Passes User Fee Reauthorization Legislation By Unanimous Vote
On May 10, the House Energy and Commerce Committee advanced the Food and Drug Administration (FDA) Reform Act of 2012, a $2.8 billion package of proposals including the Prescription Drug User Fee Act (PDUFA), the Medical Device User Fee Act (MDUFA), and the Generic Drugs User Fee Act (GDUFA), to both fund and reform the agency, by a unanimous vote involving 46 members of the House of Representatives, setting the bill up for a floor vote by the end of the month. Specifically, the bill
Both the Senate and House are expected to have a final version of the bill ready before the current law authorizing FDA user fees expires October 1, 2012.
ASCRS Submits Comments on Proposed Rule for Stage 2 of Meaningful Use of EHR
On May 7, ASCRS, in conjunction with the American Medical Association, Surgical Quality Alliance, and Alliance of Specialty Medicine, submitted three comment letters to CMS on the proposed rule for Stage 2 of meaningful use of EHRs. CMS posted the much anticipated proposed rule on February 23 of this year. The proposed rule modifies stage 1 meaningful use criteria for hospitals and eligible professionals, defines Stage 2 meaningful use criteria, and changes the clinical quality measure reporting requirement. While CMS and the Office of the National Coordinator (ONC) acknowledged the critical role that specialty providers have played in the meaningful use of health IT for quality improvement, there were few changes in the Stage 2 proposed rule beneficial to specialty care providers and provider groups feel that it is too cumbersome and would make successful physician participation extremely difficult. Changes to the proposed rule recommended by ASCRS and other provider organizations include
The final rule is expected to be published later this year. For more information, please contact Jenny Liljeberg, Associate Director of Regulatory Affairs, at jliljeberg@ascrs.org, or Nancey McCann, Director of Government Relations, at nmccann@ascrs.org.
CMS Posts Medicare EHR Incentive Program Provider Data for CY 2011
CMS has posted the 2011 Medicare Electronic Health Record (EHR) Incentive Program Eligible Professionals Public Use File (PUF) to the EHR website, which provides detailed information about EPs who attested as of December 22, 2011, including each provider's type, specialty, and his/her responses to the meaningful use core and menu measures. The report indicates that more than 225,000 providers have registered for the incentive programs, 76,612 providers have been paid, to date and more than $4.484 billion has been distributed. One of every 9 Medicare eligible physicians and professionals are meaningful users of EHRs and more than half, or 57 percent, of Medicare providers receiving incentives are specialists. Additional information on the PUF can be found on the Data and Reports page of the EHR website.
Provider Call: Current Status of Medicare Fee For Service (FFS) Implementation of HIPAA Version 5010 and D.0—Wednesday, May 16; 2:00-3:30 PM EDT
A call on the Current Status of Medicare FFS Implementation of HIPAA Version 5010 and D.0 will take place on May 16, 2:00-3:30 PM EDT. This call will address the current 5010/D.0 metrics, and discuss recommendations made by Medicare FFS, and possible outstanding fixes impacting the Part A and Part B Version 5010 transition.
Agenda:
National Provider Call — Physician Quality Reporting System & Electronic Prescribing (eRx) – Tuesday, May 22; 1:30—3:00 PM EDT
CMS subject matter experts will provide an overview of the 2013 Electronic Prescribing Payment Adjustment and an overview of the 2012 Physician Quality Reporting System/Medicare EHR Incentive Pilot.
Agenda:
A Special Thank You to All eyePAC Contributors Who Attended the Annual eyePAC Reception in Chicago.
On Friday, April 20, over 175 ASCRS eyePAC contributors and their guests gathered at the Art Institute of Chicago. The guests enjoyed a private reception where they were given a private tour leading up the grand staircase and into the 19th century impressionist art gallery. eyePAC raised $60,000 from the contributions to attend the event.
To find out more about the articles in this communication or to read more about legislative and regulatory issues that affect you and your practice, visit the ASCRS and ASOA websites. You can also visit http://www.specialtydocs.org/, the web site of the Alliance of Specialty Medicine.
© 2012 ASCRS/ASOA