Advocacy in Action

On January 18th, Congress passed a two-step continuing resolution (CR) to avert a government shutdown and extend funding through early March.

On January 17th, the Centers for Medicare & Medicaid Services (CMS) released its Advancing Interoperability and Improving Prior Authorization Processes final rule, which aims to improve the electronic exchange of healthcare data and streamline processes related to prior authorization through new requirements for Medicare Advantage (MA) organizations, state Medicaid fee-for-service (FFS) programs, state Children’s Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs).

On January 18th, CMS issued a new MLN Matters article titled, How to Use the Office & Outpatient Evaluation and Management Visit Complexity Add-on Code G2211, to provide guidance on billing the new code.

On January 18th, CMS added procedure volume data for the first time on the Medicare.gov compare tool’s physician profile pages. This tool helps patients find and compare different types of providers and to compare select quality ratings.

In late January 2024, CMS released historical quality measure benchmarks that will be used to evaluate physician performance under the 2024 MIPS program.

On January 11th, the Medicare Payment Advisory Commission (MedPAC) voted to recommend to Congress that the CY 2025 Medicare Physician Fee Schedule (PFS) conversion factor should receive a base update “50 percent of the projected increase in the MEI [Medicare Economic Index].”

The following legislations were introduced near the end of January to early February: H.R.7149, S.3679, H.R.7153, and H.R.7140.

Rep. Larry Bucshon, MD (R-Ind.) recently announced plans to retire at the end of this year. Rep. Bucshon, a cardiothoracic surgeon, has served in the House of Representatives since 2011. He also is a member of the GOP Doctors Caucus, and a senior member of the Energy and Commerce Committee.

Provisions of the No Surprises Act went into effect Jan 1, with new obligations for providers

On January 1st, the 3.37% cut to the Medicare Physician Fee Schedule (MPFS) conversion factor went into effect. This was due to the provisions of the calendar year (CY) 2024 MPFS final rule issued by the Centers for Medicare & Medicaid Services (CMS) in November of last year.