Advocacy in Action

On September 5th, the Medicare Payment Advisory Commission (MedPAC) held its first meeting in the 2024–2025 report cycle.

On September 23, 2024, CMS held an education session to provide information and address questions from industry participants regarding the Transitional Coverage for Emerging Technologies (TCET) pathway.

Starting in November 2024, CMS will begin data validation and audits (DVAs) of Merit-Based Incentive Payment System (MIPS) eligible clinicians and groups to confirm the accuracy and completeness of data reported during the 2023 performance year

If you were impacted by the Change Healthcare cyberattack in 2023 and unable to submit a MIPS Extreme and Uncontrollable Circumstances (EUC) Exception Application for performance year 2023 before the April 15, 2024, deadline, CMS is allowing requests for reweighting for one more MIPS performance categories.

On September 9th, HRS submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to the Medicare Physician Fee Schedule (PFS) and the Ambulatory Surgery Center (ASC) proposed rules for calendar year (CY) 2025.

For CY 2024, CMS introduced an Office and Outpatient Evaluation and Management (E/M) add-on code, G2211. 

CMS recently released Merit-Based Incentive Payment System (MIPS) payment adjustment information for the 2025 payment year based on 2023 performance scores.

CMS recently announced that clinicians in counties in Florida impacted by Hurricane Debby and in Texas impacted by Hurricane Beryl are eligible for an automatic Extreme and Uncontrollable Circumstances (EUC) exception from MIPS in 2024.

As part of the ongoing implementation of the Inflation Reduction Act (IRA), CMS recently announced the negotiated prices for two key heart medications under Part D, Xalerto and Eliquis, beginning January 1, 2026.

As part of the fiscal year (FY) 2025 Hospital Inpatient Prospective Payment System (IPPS) final rule, CMS finalized a new, mandatory alternative payment model (APM) that would apply to certain hospitals.