November 2018
Federal CMS agrees to improvements in E/M documentation, delays "collapse" of levels to 2021

In the 2019 proposed rule on the Medicare Physician Fee Schedule (PFS), the Centers for Medicare and Medicaid Services (CMS) proposed revisions to the E/M documentation guidelines intended to reduce administrative burden on physicians. In addition, the federal CMS proposed coding and payment changes to new and established office visit services. The AMA led the development of a joint comment letter from 170 physician and other health professional organizations calling for the agency to finalize several proposed changes to E/M documentation guidelines for CY2019.

"The AMA is pleased to report that the federal CMS is implementing the documentation policies, which will significantly reduce administrative burden and allow all physicians to spend more time with their patients," the AMA stated.

The agency has also acknowledged the work of the AMA's CPT/RUC Workgroup on E/M and has postponed any coding and payment-related changes for E/M office visit services until CY2021. This delay in implementation will allow the CPT Editorial Panel to consider the workgroup's proposal in February 2019 prior to prompt consideration by the AMA/Specialty Society RVS Update Committee (RUC).

On page 584 of the rule, the federal CMS states:

"We recognize that many commenters, including the AMA, the RUC, and specialties that participate as members in those committees, have stated intentions of the AMA and the CPT Editorial Panel to revisit coding for E/M office/outpatient services in the immediate future. We note that the two-year delay in implementation will provide the opportunity for us to respond to the work done by the AMA and the CPT Editorial Panel, as well as other stakeholders. We will consider any changes that are made to CPT coding for E/M services, and recommendations regarding appropriate valuation of new or revised codes."

The Colorado Medical Society continues to coordinate with the AMA.
 

Alert: Extortion scam targeting DEA registrants

The Drug Enforcement Administration (DEA) reports that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel. This issue first came to light last spring but is again on the rise. 
 
The criminals have masked their telephone number on caller ID by showing the DEA Registration Support 800 number. Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant's DEA registration. 

If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through "Extortion Scam Online Reporting" posted on the DEA Diversion Control Division's website, www.DEADiversion.usdoj.gov.

Final rule for QPP Year 3 (2019) released

On Nov. 1, the federal CMS released the Final Rule for Year 3 (2019) of the Quality Payment Program. This rule does NOT affect the remainder of 2018.

For Year 3, the agency continues to build on what has been working and has used physician-provided feedback to improve program policies. In terms of quality measures, Year 3 continues to identify low-value or low-priority process measures and focus on meaningful quality outcomes for patients and streamlined reporting for clinicians. Below are just a few of the changes that could have the largest impact on practices:
  • Expanding MIPS-eligible clinician types to include physical therapists, occupational therapists, speech-language pathologists, audiologists, clinical psychologists, and registered dietitians or nutrition professionals
  • Adding "Number of Covered Professional Services" to the low-volume threshold determination. Also there will be an opt-in policy that offers eligible clinicians who meet or exceed one or two elements of the low-volume threshold the option to participate in MIPS
  • Medicare Part B claims measures can be submitted by clinicians in small practices, either individually or as a group
  • Individuals and groups can submit measures through multiple collection types
  • Weighting: Quality 45%, Cost 15%, Promoting Interoperability 25%, Improvement Activities 15%
  • Performance threshold is 30 points
  • Change to small practice bonus - 6 bonus points are added to the numerator of the Quality performance category
To learn more about the Year 3 Quality Payment Program policies, review the following resources:
  • Press release - includes more details about the announcement
  • Executive Summary - provides a high-level summary of the Quality Payment Program Year 3 final rule policies
  • Fact Sheet - offers an overview of the policies for Year 3 (2019) and compares these policies to the current Year 2 (2018) requirements
Download Episode 3 of Telligen's Speaking Out on Pain Management podcast

Episode 3 of the Speaking Out on Pain Management podcast brings listeners the voices of pharmacists as they discuss the serious disconnect that can happen between providers, patients and pharmacists when prescribing opioids. They share tips and resources that physicians and their staffs can use for the management of chronic pain with regards to opioids. Download the podcast here.
New Medicare Card mailing update - Wave 6 (Colorado) ends

The federal CMS finished mailing cards to people with Medicare who live in Waves 1-6 and continues to mail to Wave 7 states (Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Puerto Rico, Tennessee and the Virgin Islands).
 
If someone with Medicare says they did not get a card, you should instruct them to:
  • Sign into MyMedicare.gov to see if we mailed their card. If so, they can print an official card. They will need to create an account, if they do not already have one.
  • Call 1-800-MEDICARE (1-800-633-4227) where we can verify their identity, check their address, and help them get their new card.
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Important! What your practice needs to know about switching to EMV: Click here.
 



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