The ACR and 315 other organizations have publicly said savings would not be achieved by the demonstration project and that it will reduce access to care for patients…
How to Leverage Patient Satisfaction
Medicare and other insurers are using patient satisfaction to determine provider payment. But according to one expert, rheumatologists who look at their practice with a critical eye, listen and ask their patients the right questions may improve their patient relationships and their practice…
The ACR Continues Fight to Block Medicare Part B Demo Project: Rule Expected in Fall 2016
The ACR will seek Congressional action if the Medicare Part B demonstration project proposed by the Centers for Medicare & Medicaid Services (CMS) is not significantly altered by the agency. Today, Medicare Part B generally pays physicians and hospital outpatient departments the average sales price of a drug, plus a 6% add-on, minus reductions required…
Proposed CMS Physician Fee Schedule May Offer Slight Increases
All eyes are on the new physician fee schedule proposed by the Centers for Medicare & Medicaid Services (CMS), which will be finalized this year and go into effect Jan. 1. The ACR is reviewing the proposal and will be providing comments and recommendations to CMS. And many rheumatologists have payment and coding questions: Will…
Medicare Sets Standards for Overpayments Received by Physicians, Healthcare Providers
In February 2016, the Centers for Medicare & Medicaid Services (CMS) published the final rule on Medicare Reporting and Returning of Self-Identified Overpayments. This final rule from CMS has now established official policy for timely reporting and returning of Medicare overpayments received by healthcare providers, with a goal to provide clear requirements for reporting and…
The ACR Opposes Part B Payment Demo & Other Highlights from the AMA HOD Meeting
On June 15, the ACR and partnering physician specialist groups passed an American Medical Association (AMA) resolution opposing the proposed Medicare Part B drug payment demonstration during the AMA House of Delegates (HOD) meeting held June 11–15 in Chicago. Part B Payment Demo Resolution The resolution, which the ACR supported with the American Society of…
Prepare Now to Survive MACRA
The year 2015 brought an end to the much-maligned Sustainable Growth Rate (SGR), sometimes known as the “doc fix.” The SGR established limits on Medicare reimbursement for physicians, and each year, physicians and those lobbying on their behalf were forced to stave off drastic cuts to their payments. “The SGR was Congress’s attempt to control…
CMS Commences 45-Day Open Payments Review & Dispute Period
On April 1, the Centers for Medicare and Medicaid Services (CMS) announced the beginning of the 45-day Open Payments Review and dispute period, which will conclude on May 15. After the review period concludes, on June 30, CMS will publish 2015 payment data along with updates to the 2013 and 2014 data. If you are…
U.S. Health Agency Estimates 2015 Prescription Drug Spending Rose to $457 Billion
NEW YORK (Reuters)—Spending on prescription drugs is projected to have risen to $457 billion in 2015 and will likely continue to grow as a percentage of overall healthcare spending, a U.S. government health agency said on Tuesday. That is an increase of about 8% from 2014’s prescription drug spending, which is also an estimated figure,…
U.S. Proposes Hike in Medicare Advantage Payments; Insurer Shares Rise
NEW YORK (Reuters)—The U.S. government on Friday proposed raising payments by 1.35% on average next year to the health insurers who offer Medicare Advantage health benefits to elderly and disabled Americans. Payments to insurers will vary under the 2017 Medicare Advantage proposal, based on the region the plans are sold and on the size of…
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