Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings…
Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program
SUMMARY: This major proposed rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies.
DATES: To be assured consideration, comments must be received at one of the addresses provided below, no later than
ADDRESSES: In commenting, please refer to file code CMS-1676-P. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission.
You may submit comments in one of four ways (please choose only one of the ways listed):
1. Electronically. You may submit electronic comments on this regulation to www.regulations.gov. Follow the instructions for "submitting a comment."
2. By regular mail. You may mail written comments to the following address ONLY:
Please allow sufficient time for mailed comments to be received before the close of the comment period.
3. By express or overnight mail. You may send written comments to the following address ONLY:
4. By hand or courier. If you prefer, you may deliver (by hand or courier) your written comments before the close of the comment period to either of the following addresses:
a. For delivery in
(Because access to the interior of the
b. For delivery in
If you intend to deliver your comments to the
FOR FURTHER INFORMATION CONTACT:
Tourette Jackson, (410) 786-4735, for issues related to the valuation of musculoskeletal services, allergy and clinical immunology services, endocrinology services, genital surgical services, nervous system services, INR monitoring services, injections and infusions, and chemotherapy services.
Wilbert Agbenyikey, (410) 786-4399, for issues related to MACRA patient relationship categories and codes.
SUPPLEMENTARY INFORMATION:
Table of Contents
I. Executive Summary
II. Provisions of the Proposed Rule for PFS
A. Background
B. Determination of Practice Expense Relative Value Units (PE RVUs)
C. Determination of Malpractice Relative Value Units (MRVUs)
D. Medicare Telehealth Services
E. Potentially Misvalued Services Under the PFS
F. Implementation of Reduced Payment for Film-Based Imaging Services
G. Proposed Payment Rates Under the Medicare PFS for Nonexcepted Items and Services Furnished by Nonexcepted Off-Campus Provider-Based Departments of a Hospital
H. Proposed Valuation of Specific Codes
I. Evaluation & Management (E/M) Guidelines and Care Management Services
III. Other Provisions of the Proposed Rule
A. New Care Coordination Services and Payment for
C. Solicitation of Public Comments on Initial Data Collection and Reporting Periods for Clinical Laboratory Fee Schedule
D. Solicitation of Public Comments on Biosimilars
E. Appropriate Use Criteria for Advanced Diagnostic Imaging Services
F. Physician Quality Reporting System Criteria for Satisfactory Reporting for Individual EPs and Group Practices for the 2018 PQRS Payment Adjustment
G. Medicare EHR Incentive Program
H. Medicare Shared Savings Program
I. Value-Based Payment Modifier and Physician Feedback Program
J. MACRA Patient Relationship Categories and Codes
K. Medicare Diabetes Prevention Program
IV. Collection of Information Requirements
V. Response to Comments
VI. Regulatory Impact Analysis
Regulations Text
Acronyms
In addition, because of the many organizations and terms to which we refer by acronym in this final rule, we are listing these acronyms and their corresponding terms in alphabetical order below:
A1c Hemoglobin A1c
ACO Accountable care organization
ASC Ambulatory surgical center
ATRA American Taxpayer Relief Act (Pub. L. 112-240)
AWV Annual wellness visit
BBA Balanced Budget Act of 1997 (Pub. L. 105-33)
BBRA [Medicare, Medicaid and State Child Health Insurance Program] Balanced Budget Refinement Act of 1999 (Pub. L. 106-113)
CAD Coronary artery disease
CAH Critical access hospital
CBSA Core-Based Statistical Area
CCM Chronic care management
CEHRT Certified EHR technology
CF Conversion factor
CG-CAHPS Clinician and Group Consumer Assessment of Healthcare Providers and Systems
CLFS Clinical Laboratory Fee Schedule
CoA Certificate of Accreditation
CoC Certificate of Compliance
CoR Certificate of Registration
CNM Certified nurse-midwife
CP Clinical psychologist
CPC Comprehensive Primary Care
CPT [Physicians] Current Procedural Terminology (CPT codes, descriptions and other data only are copyright 2015 American Medical Association. All rights reserved.)
CQM Clinical quality measure
--This is a summary of a
Proposed rule.
CFR Part: "42 CFR Parts 405, 410, 414, 424, and 425"
RIN Number: "RIN 0938-AT02"
Citation: "82 FR 33950"
Document Number: "CMS-1676-P"
Federal Register Page Number: "33950"
"Proposed Rules"
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