Advocacy in Action

June 29, 2023 - In accordance with the American Medical Association (AMA) Category III CPT code semi-annual early release schedule, new dual-chamber leadless pacemaker codes (0795T-0804T) will be effective July 1st, and published in the 2024 CPT Code book. View the PDF for more information.

June 29, 2023 - With the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) proposed rule estimated for release at the beginning of July, Congress is starting to consider what steps it might potentially take to avert expected 2024 payment year cuts.

June 29, 2023 - The Medicare Payment Advisory Commission (MedPAC) has released its June 2023 report to the Congress on Medicare and the Health Care Delivery System. On June 15th, the Medicaid and CHIP Payment and Access Commission (MACPAC) also released its June 2023 report, which includes a chapter on payment policy for safety net hospitals, recommending the creation of automatic adjustments to disproportionate share hospital (DSH) payments.

June 29, 2023 - In April, the Environmental Protection Agency (EPA) released a proposed rule, National Emission Standards for Hazardous Air Pollutants: Ethylene Oxide Emissions Standards for Sterilization Facilities Residual Risk and Technology Review.  The letter, signed by several societies, urges caution given the potential unintended consequences of such a rule.

June 29, 2023 - On June 22nd, CMS released its long-awaited proposed procedural notice that outlines a new voluntary, expedited Medicare coverage pathway for certain FDA-designated Breakthrough Devices. Under the Transitional Coverage for Emerging Technologies (TCET), manufacturers would be able to address any evidence gaps through fit-for-purpose studies, where the study design, analysis plan, and data are appropriate for the question the study aims to answer.

June 29, 2023 - CMS recently released its most recent QPP Experience Report, reflecting data on clinician eligibility, participation, and performance related to the 2021 performance year of the Merit-Based Incentive Payment System (MIPS) and Qualifying Advanced Payment Model Participants (QPs). An accompanying QPP Public Use File (PUF) includes more detailed information related to individual clinicians who received a 2021 MIPS final score.

June 29, 2023 - Physicians who were eligible to participate in the MIPS program in 2022 can now access a preview of their performance scores before CMS releases final performance scores and associated 2024 payment adjustment amounts in August.

May 31, 2023 - The COVID-19 public health emergency (PHE) officially expired on May 11th. The end of the PHE will see the private sector begin to assume much of the responsibility for vaccine and treatment distribution. 

May 30, 2023 - Congress and the White House continue negotiations to address crossing the national debt limit set by Congress. At the time of this publication, the path to resolution is unclear. However, because significant financial fall out is anticipated if Congress does not address the issue, there continues to be hope that a deal will be reached prior to the federal debt limit being crossed sometime in early June.

May 30, 2023 - On April 10th, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2024 Hospital Inpatient Prospective Payment System (IPPS) proposed rule. While physicians are subjected to payment reductions via the Medicare Physician Fee Schedule, hospitals continue to receive positive payment updates because of inflationary adjustments being built into their reimbursement formula.