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Ensure payment and avoid policy violations. Plus, new resources to help you navigate the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Access helpful forms developed by a variety of sources for patient charts, logs, information sheets, office signs, and use by practice administration.
ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
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Because of ACP advocacy and policy development efforts, working with other allied organizations:
Medicare is now paying you and your staff for work outside of a face-to-face visit involved with transitioning a patient from the hospital to the community setting-as much as $231 for each time you bill for this service under new codes that became effective on January 1, 2013. Greater detail is included below:
Medicare will soon be paying you and your staff for work outside of a face-to-face visit involved with chronic care management-starting on January 1, 2015, the Centers for Medicare and Medicaid Services (CMS) will begin making a separate payment via a G-code for non-face-to-face chronic care management services for Medicare beneficiaries who have multiple (two or more), significant chronic conditions. Greater detail is included below:
The annual Sustainable Growth Rate (SGR) cut that would have gone into effect on January 1, 2014 has been averted for 90 days and a comprehensive Medicare payment reform bill that would permanently repeal the SGR has been reported out of the major congressional committees of jurisdiction. Greater detail is included below:
Starting on January 1, 2013 and continuing through 2014, Medicaid payments to internists for their evaluation and management services and vaccine administration are no less than the comparable Medicare rates. Greater detail is included below:
In addition to the Medicaid payment increases outlined above, Medicare will continue to pay a 10 percent bonus to primary care internists, and other primary care physicians, for your office visits and other evaluation and management codes-an average annual increase in Medicare revenue of an estimated $5,000 per internist over the course of 5 years (from 2011 to 2015). Greater detail is included below:
More and more individuals are getting access to health insurance coverage either via the state health insurance marketplaces or the expansion of Medicaid. Greater detail is included below:
Programs that you and your patients depend on to ensure: (1) access to public health services, (2) the undertaking of critical medical research, and (3) an adequate physician workforce were protected. Greater detail is included below:
Five hundred primary care practices in seven regions are receiving substantial increases in Medicare revenue-plus financial and other support services from other payers in their communities-for providing patient-centered, coordinated care. Greater detail is included below:
ACP members, other physicians, patients, policymakers, and key stakeholders can depend on the College to address controversial and complex issues of importance to internists... Greater detail is included below:
Download a PDF version of the list here.
These codes include:
In order to succeed in this new environment of payment for team-based care, dynamic clinical care teams and nimble, adaptable partnerships that encourage collaboration and smooth transitions of responsibility that are focused on patient needs will be required. Therefore, ACP has drafted a set of key "Principles Supporting Dynamic Clinical Care Teams" that will help physicians prepare for the rapidly evolving delivery and payment system environment-one that is moving toward payment for value rather than volume of services.
Chronic care management services are defined to include the development, revision, and implementation of a plan of care; communication with the patient, caregivers, and other treating health professionals; and medication management-and will be paid to a physician or other eligible practitioner from a qualified practice that furnishes these services over 30-day periods. The specific payment amount for this G-code (GXXX1) and the detailed standards that will be required for a practice to qualify to provide these services will be determined over the course of the coming year.
This includes a single website that will be established, whereby group practices can make multiple elections for both PQRS and VBPM, as well as other CMS programs. Additionally, the CY2016 VBPM will use all of the PQRS measures available to be reported under the various PQRS reporting mechanisms in CY2014, including quality measures reported by individual eligible professionals in a group through "quality clinical data registries" (QCDRs), to calculate a group of physicians' VBPM in CY2016.
In order to find out more about the PQRS and VBPM programs, you can access ACP's Physician and Practice TimelineSM. The Timeline provides a helpful at-a-glance summary of upcoming important dates related to a variety of regulatory, payment, educational, and delivery system changes and requirements-including VBPM, PQRS, Meaningful Use, ICD-10, the Sunshine Act, the transitional care management codes, and Maintenance of Certification (MOC).
This change, also mandated by the ACA, was designed to make it more feasible for eligible physicians to take care of Medicaid patients, both in states that are expanding the program to everyone up to 138 percent of the Federal Poverty Level (as also authorized by the ACA) as well as in states that have not yet agreed to the expansion. Although many states have been slow to roll this out, it is a very substantial increase in Medicaid payments in most states and, in most cases, will be retroactive to the beginning of 2013. And, as advocated for by ACP, this increase applies to both general internists as well as internal medicine subspecialists-and includes services that are not currently paid for under Medicare, such as the consultation services codes. ACP is advocating to extend this program beyond 2014.
The average index of Medicaid/Medicare payment throughout the country is 66 percent; therefore, this change has or will result in substantial increases in payments to most physicians providing primary care services to Medicaid patients-and, as noted above, is not limited by specialty designation.
We also have more information on the Medicaid "Pay Parity" provision of the ACA, including ACP's analysis and frequently asked questions (FAQs).
ACP was a driving force behind Congress' creation of this program, also mandated and funded by the ACA, including persuading CMS to greatly expand the number of internists who will qualify for the bonus. Based on the most recent CMS report, nearly half of all the bonus payments in 2012 went to internists-the most of any specialty-with a total pay-out of $327,923,480 or an average of nearly $5,000 per internist. These payment increases are a direct result of ACP advocacy. ACP is advocating to extend this program beyond 2015.
While the roll out of the ACA has not been as smooth as many would have liked, the health insurance marketplaces have launched and patients who need coverage will be able to enroll until March 31, 2014. To help you help your patients determine health insurance choices, as well as to answer questions that you might have, ACP has put together a series of documents to address questions about the changes in healthcare coverage brought about by the new marketplaces. These resources include:
The Bipartisan Budget Act of 2013 (BBA) was signed into law on December 26, 2013. The BBA provides much-needed respite from sequestration (across-the-board budget cuts), restoring about $23 billion or almost two-thirds of the scheduled sequestration cuts for nondefense discretionary programs in FY2014.
Additionally, a separate and related omnibus appropriations bill, enacted in January 2014, ensures the following:
ACP was among the most vocal national physician membership organizations in advocating that Congress replace the sequestration cuts with a more responsible approach that ensures adequate funding for essential health programs.
ACP has been actively engaged in advising on this project from its inception. CMS is paying the participating primary care practices a risk-adjusted care management fee, initially set at an average of $20 per beneficiary per month, to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries and, when proven to be successful, the Secretary of Health and Human Services has the authority to roll out this payment approach throughout all of fee-for-service Medicare.
This program, called the 4-year Comprehensive Primary Care (CPC) Initiative, was kicked off by the CMS Innovation Center with the intent of fostering collaboration between public and private health care payers to strengthen primary care in the U.S. The CPC initiative extends and builds upon the PCMH concept to include payment reform to support practice transformation. The initiative includes 500 primary care practices, representing 2,144 clinicians, that serve an estimated 313,000 Medicare beneficiaries. ACP played a critical role in helping the Innovation Center design the program and in encouraging internal medicine practices to enroll in it.
Additionally, in the SGR legislation described earlier, this is the only project without a requirement for physicians to share risk for financial losses that would be automatically considered an Alternative Payment Model (APM)-all other APMs must have this "two-sided risk" component. Therefore, if the legislation passes, the current participating practices-plus any new practices added once it is proven successful-could become eligible to receive a 5 percent payment bonus in 2017 through 2022, followed by a 2 percent bonus in subsequent years.