MGMA Sends Congress Year-end Legislative Recommendations

Originally published in the November 17, 2022, issue of MGMA Washington Connection
Reprinted with permission from MGMA

On Monday, MGMA sent a letter to congressional leadership urging them to address significant Medicare cuts and other important healthcare policies before the end of this year. The letter highlights current issues with Medicare reimbursement that projected payment cuts will exacerbate and asks Congress to act by:

• Offsetting the 4.47% reduction to the Medicare physician conversion factor;
• Waiving the 4% statutory Pay-As-You-Go sequester; and,
• Extending the 5% alternative payment model (APM) incentive payment for six additional years.

Further, MGMA encouraged Congress to pass additional commonsense legislation to address significant administrative burdens impacting group practices and improve the timeliness of clinical care delivery. These recommendations included passing the Improving Seniors’ Timely Access to Care Act, extending telehealth waivers for at least two years after the conclusion of the public health emergency, passing the Saving Access to Laboratory Services Act, and appropriating additional funds to continue rewarding high performing clinicians within the Merit-based Incentive Payment System (MIPS).

Visit MGMA’s Contact Congress portal to send a letter to your legislators on these important issues!

Issue Spotlight: Proposed Changes to Medicare E&M Visits

Originally published in the July 18, 2018 issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

The Centers for Medicare & Medicaid Services (CMS) released the 2019 Medicare Physician Fee Schedule proposed rule that would affect Medicare physician reimbursement policies beginning in 2019. Among other changes, CMS proposes to:

• Collapse evaluation and management (E&M) Levels 2-5 into one level for new patients and another for established patients. The average national payment would be $135 for new patients and $93 for established patients.
• Allow clinicians to choose to document office and outpatient E&M visits using medical decision-making or time or continue using the current 1995 or 1997 E&M documentation guidelines.
• Create a minimum documentation standard so clinicians would only need to meet requirements currently associated with a level 2 visit for history, exam, or medical-decision making (except when using time to document the service).

To help MGMA evaluate the impact of these proposed changes and advocate on behalf of medical group practices, please share your feedback on these proposals by filling out this brief comment form.