Washington Report from MGMA

Originally published in the November 11th issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

Legislation introduced to provide broad Meaningful Use 2015 hardship exception
Rep. Tom Price, MD (R-Ga.) recently introduced H.R. 3940, the “Meaningful Use Hardship Relief Act of 2015.” This bill would ensure that the Centers for Medicare & Medicaid Services (CMS) could grant broad relief to eligible professionals (EPs) and other providers from the 2015 EHR Incentive (Meaningful Use) Program due to the delay in publication of the Meaningful Use final modifications rule. MGMA wrote a letter of support for the bill. While there are currently a number of hardship exceptions available, EPs are required to apply individually and each application is reviewed on a case-by-case basis. H.R. 3940 would provide a practical solution to this problem by amending the meaningful use statute to allow for a blanket exception for EPs in 2015.

Visit the MGMA Advocacy Center to contact your lawmakers and ask them to support the legislation.

OIG releases FY 2016 Work Plan
The Department of Health and Human Services Office of Inspector General (OIG) released its FY 2016 Work Plan, which describes OIG audits, evaluations, and certain legal and investigative initiatives that are new or ongoing in FY 2016. According to the work plan, in FY 2016 and beyond, OIG “will expand its focus on delivery system reform and the effectiveness of alternative payment models, coordinated care programs and value-based purchasing.”

CMS announces call for new RAC contracts
On Nov. 6, the Centers for Medicare & Medicaid Services (CMS) released Requests for Proposals for the next round of Recovery Auditor Contractor (RAC) contracts. As CMS continues the procurement process for the next round of RAC contracts, the agency will begin to close out current contracts so that RACs can complete all outstanding claim reviews and other processes by Dec. 31, 2015, the end date of the current contracts. CMS is also pursuing contract modifications to the current contracts to allow each of the four existing RACs to continue auditing activities through July 31, 2016.

Once RACs sign the contract modification, they may resume recovery auditing activities, including sending additional documentation requests (ADRs). In the event that a RAC does not sign a modified contract and allows the current contract to expire, any remaining ADRs must have been sent by Oct. 16, 2015 and any improper payment files must be sent to Medicare Administrative Contractors for adjustment by Dec. 31, 2015.

Medicare changes coming in 2016; MGMA member-benefit webinar breaks down what you need to know
On Oct. 30, the Centers for Medicare & Medicaid Services (CMS) released the final 2016 Medicare Physician Fee Schedule (PFS), setting payment rates for Medicare physician services next year with a CY 2016 PFS conversion factor of $35.8279, among other critical changes to federal quality reporting programs and Medicare policies. To gauge how your practice will be impacted by RVU and billing changes, CMS provides two valuable tables. The first demonstrates the impact on 2016 payment for high volume services billed under the fee schedule. The second displays the estimated impact on total allowed charges by specialty.

To learn more about Medicare payment updates on the horizon, join MGMA Government Affairs for our annual Medicare Update Webinar, to be hosted live on Dec. 3 from 1 to 2:15 PM ET. This 75-minute webinar is offered at no cost to members and will overview the key features you need to know from the 2016 final PFS and feature a live Q&A session where our experts take your questions. Space is limited, so register early!


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