The National Association for Medical Direction of Respiratory Care

The Washington Watchline

CMS Moves to Increase the Adoption of New Medical Technology

The Centers for Medicare and Medicaid Services (CMS) has released the proposed 2020 Outpatient Prospective Payment System (OPPS) rule and the finalized 2020 Inpatient Prospective Payment System (IPPS) rule. Under the OPPS, the position of the Administration in regard to the effort to move to site neutral payments remains unchanged. In the IPPS, the Administration rejected requests for endobronchial valve procedures and for percutaneous extra corporeal membrane oxygenation (ECMO) to be considered operating room procedures for payment. 

Medicare’s Evolving Payment Policy for Outpatient Care

In addition to the proposed changes to the Merit-based Incentive Payment System (MIPS), discussed in last month’s Washington Watchline, the Centers for Medicare & Medicaid Services (CMS) has proposed significant upgrades to compensation for outpatient evaluation and management (E&M) services.

The Proposed 2019 Medicare Physicians Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the 2020 Physician Fee Schedule (PFS) and Quality Payment Program (QPP) on Monday July 29. In this proposed rule, CMS continues to emphasize the themes of accurately profiling the value of individual physician’s services, adjusting payment policies to enhance payment for primary care and promoting telecommunication services.

MedPAC Guidance to Congress on Medicare’s Physician Compensation

In addition to promoting innovative treatments for patients with pulmonary disease, sleep disorders and the critically ill, one of NAMDRC’s primary issues is fair physician compensation consistent with their training, expertise and contribution to patient care. As the major purchaser of healthcare, Medicare payment policy influences the payment policies of most commercial insurers.

The Proposed 2020 Medicare Payment for Hospital Services

On April 23, 2019, the Centers for Medicare & Medicaid Services (CMS) released the proposed Inpatient Prospective Payment System (IPPS) rule for 2020. CMS has indicated that its goal for 2020 is to transform the healthcare delivery system by implementing regulations that promote competition and innovation. Policies proposed in this rule focus on “rethinking rural health” and “unleashing innovation.” Efforts to address rural health care include proposals to increase the wage index of low wage index hospitals.

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