Latest News

  • 14 Jul 2017 7:49 AM | Anonymous
    July 13, 2017

    Regulatory Alert: CMS releases proposed 2018 Medicare physician fee schedule

    The Centers for Medicare & Medicaid Services (CMS) released the proposed Medicare physician fee schedule (PFS) rule for 2018. CMS will accept public comments on the rule until Sept. 11, 2017 and intends to issue the final 2018 PFS by Nov. 1, 2017. Visit our updated Medicare Physician Reimbursement webpage to view the full proposed 2018 Medicare PFS and read the CMS fact sheet under the "Other Resources" section.

    Among other changes, the proposed rule would:
    • Set 2018 Medicare payment rates for physician services, including a modest payment increase as a result of SGR repeal under the Medicare Access and CHIP Reauthorization Act;
    • Outline proposed RVU and payment changes for services CMS considers misvalued; 
    • Delay the start of the Appropriate Use Criteria (AUC) program until Jan. 1, 2019 and posts the list of newly approved Provider-Led Entitles and Clinical Decision Support Mechanisms, which will develop and document AUC for advanced diagnostic imaging services;
    • Retroactively lower PQRS reporting requirements to six measures;
    • Reduce Value-Based Payment Modifier penalties and hold groups harmless if they meet minimum quality reporting requirements; and
    • Seek input through a Request for Information about opportunities to reduce burdens on physician practices and make the delivery system less bureaucratic and complex.
    In a separate rule, CMS proposed changes to policies and payments regarding hospital outpatient departments and ambulatory surgical centers.

    MGMA will prepare an in-depth analysis of the proposed 2018 Medicare PFS for members and submit comprehensive comments to the agency. Stay tuned to the MGMA Washington Connection for updates and contact MGMA government affairs with questions by emailing govaff@mgma.org or calling 202.293.3450877.275.6462 toll-free.

  • 21 Jun 2017 6:26 AM | Anonymous
    June 20, 2017

    Regulatory Alert: Medicare proposes 2018 MIPS and APM changes

    Today, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule changing the Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs) participation options and requirements for 2018. Key provisions of the proposed rule would:
    • Establish MIPS reporting requirements for 2018;
    • Delay the previously-finalized 2018 requirement to upgrade 2014 Certified EHR Technology to the 2015 edition;
    • Increase the low-volume threshold;
    • Delay implementation of the cost component of MIPS;
    • Incorporate the option to use facility-based scoring for facility-based clinicians;
    • Offer the virtual group option for solo and small practices to aggregate their data for a shared MIPS evaluation; and
    • Outline criteria for qualification as a participant in an all-payer APM, beginning in 2019.
    MGMA Government Affairs staff are closely reviewing the proposed rule and will provide additional information to members in the coming weeks. The Association will submit detailed comments in response to these proposals to CMS. The agency will be accepting public comments on the proposed rule until Aug. 21, 2017. A link to the proposed rule and additional information is posted on MGMA's MACRA Resource Center.  
  • 01 Jun 2017 5:44 AM | Anonymous

    05/31/2017

    NV MGMA Membership - Legislative update

    Call to action

    This session has included a myriad of healthcare issues, but as the final days come into focus, there are several issues around the payment for emergency services to providers and hospitals that remain unresolved and threaten the viability of those services within the state.

    Two bills were introduced to address Out-of-Network payments for providers who care for emergent patients.  The Senate Bill promulgated by NSMA and MGMA, sponsored by Senator (and Doctor) Joe Hardy has died in Committee.  That bill would have used market-rate charges to identify the payments required by insurance companies.

    AB382 is still alive and gets worse for physicians on every amendment.  In its current form, physicians would be required to accept as payment the 1) “average amount negotiated by the third party for in-network care” (no word on how this would be determined or verified), 2) 125% of Medicare or 3) arbitration.  We had worked hard to make arbitration something we could live with but in this version, the expense is split between both parties which is untenable for the vast majority of ER bills, which average a charge of $770 for an ER provider bill, the timeframes and steps are onerous and the guiding principles for the arbitrator to consider don’t include protective guidance about what should be considered.

    Additionally, in late May, Maggie Carlson introduced AJR14 (first hearing was yesterday) which would rate-set the hospitals to 115% of Medicare for their emergency care. 

    • Providers aren’t included, but we de facto are because this influences the hospitals ability to pay for ER Call and the like.
    • Joint Resolutions (this is an Assembly JR) do not cross the Governor’s desk, so there is no opportunity for a veto.  They must pass two sessions in a row then go to a vote then become a constitutional amendment.  We would have rate-setting for emergency care in the Nevada Constitution. 

    What are we doing?

    Highly disturbing?  Correct!  The Nevada Medical Association (Catherine O’Mara) and their lobbyists have taken the lead on this fight.  NV MGMA has engaged through their association and has been present for negotiations, document reviews, drafting of compromises and the like.  Jeff Snyder, Donna Juell and I have offered suggestions, crafted responses, given testimony (I have testified 3 times on these issues), met with the Governor’s office (multiple times including yesterday).  We were met by an absolute unwillingness to negotiate on our bill.  Although they engaged us on AB382, it appears that none of that was taken to heart since the most recent amendment is worse than the original bill.  One can only assume it was a tactic to run out the clock.

    What can you do?

    Until the last amendment broke late Friday afternoon, we had been hopeful to have a reasonable compromise.  Sadly, the language put out was worse.  It is probably by design to allow us no time to rally the troops.  What you can do includes

    • Call your legislators, particularly those in the Senate and let them know you OPPOSE AB382 and AJR 14.  Click here to find your State Senator and State Assemblyman.
    • Review and distribute the attached flier (Click here for flyer)
    • Watch your email and plan to attend, sign-in in opposition at the next hearing for either/or both bills. 

     

    Karen Massey, MHA, FACMPE, CPMSM

     

  • 22 May 2017 10:56 AM | Anonymous

    Practitioners in Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island are required to report on claims data on post-operative visits furnished during the global period of specified procedures using CPT code 99024, beginning July 1, 2017. 

    The specified procedures are those that are furnished by more than 100 practitioners and either are nationally furnished more than 10,000 times annually or have more than $10 million in annual allowed charges. Practitioners who only practice in practices with fewer than 10 practitioners are exempted from required reporting, but are encouraged to report if feasible. 

    Although reporting is required for global procedures furnished on or after July 1, 2017, we encourage all practitioners to begin reporting as soon as possible.

  • 27 Dec 2016 8:47 AM | Anonymous

    There have been changes to the ACMPE certification eligibility criteria, plus the 2017 AMPE Exam dates have been published — with a link to the ACMPE page so that everyone can access it easily.

    Please visit our ACMPE Certification page for full details.

    We would love to see more of our Nevada Members obtain Certification and we are here to help!

    If you have any questions, contact me.

    Jackie Shoupe, FACMPE
    j.shoupe@sbcglobal.net
    (775) 329-8423
    ACMPE Forum Representative for Nevada MGMA

  • 22 Feb 2016 12:28 PM | Anonymous

    CMS formally reaffirms 2015 MU hardship exception does not nullify incentive opportunity

    In direct response to MGMA, the Centers for Medicare & Medicaid Services published a formal FAQ stating that an eligible professional (EP) may submit a hardship exception application, while still remaining eligible for an incentive payment if they successfully attest for 2015 Meaningful Use (MU). MGMA continues to encourage all EPs to take advantage of this opportunity for the 2015 reporting year and apply for the hardship exception, even if they plan to attest. This simple process will provide an extra layer of protection against potential penalties. Review MGMA's member-benefit 2015 MU hardship exception resource.

    Key dates:

    • March 11, 2016 – 2015 MU attestation deadline
    • March 15, 2016 – 2015 MU hardship exception application deadline


  • 09 Feb 2016 8:30 AM | Anonymous

    This tip sheet was developed by Karen Massey (last updated on 2/9/2016) based on materials from the Nevada Office of Vital Records and is intended only as assistance. For specific rules and requirements, please contact the Nevada Office of Vital Records.

    The NV State Medical Association is working on the Death Certificate issue and has obtained some useful results such as help desk hours on the weekend. 

    Please CLICK HERE to view the Tip Sheet that I developed for our group's internal use, and I am happy to share it with my colleagues in MGMA.  There are only 4 tabs that require completion for providers, and that is not readily obvious within the system.  I hope you find it helpful and we will provide updates as we are able to make more advances on this issue.

    Karen Massey, MHA, FACMPE, CPMSM
    NV MGMA Legislative Liaison
    Executive Director, Northern Nevada Emergency Physicians